Abstract
Lobectomy resections for malignant tumours is a common procedure that allows for potential curative resection, histological diagnosis and eventual discussions of adjuvant treatment options. This case discusses a 75-year-old male who presented for right upper lobectomy for a suspicious lesion within the lung on PET-CT. FNA showed large cell malignant features whilst core biopsy was inconclusive. On macroscopic dissection of the specimen it was noted that two distinct and morphologically different lesions existed within the parenchyma. Microscopic assessment of the suspicious lesion showed a pleomorphic lung carcinoma and the second lesion a cryptococcoma. In addition, the background lung tissue showed a lymphocytic infiltrate that was ultimately confirmed as chronic lymphocytic leukaemia/lymphoma. The patient was commenced on fluconazole treatment, has bone marrow progressive CLL and remains reoccurrence free for the pleomorphic lung carcinoma. This case highlights the rare instances where meticulous investigation of specimens can yield additional pathologies that can alter treatment in patients with active infection and immunosuppression.
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