English

Abstract

Non Resolving pneumonias always present a difficult problem. Sometimes despite every effort, the diagnosis is not obvious. We report a case of ductal carcinoma of breast presenting as nonresolving pneumonia in a female patient with dry cough and bilateral crackles on physical examination. An initial CT Thorax showed pneumonic patches in the lingula and middle lobe. There was also mediastinal lymphadenopathy. She was evaluated by bronchoscopic procedures which were inconclusive except for chronic inflammation seen on trans-bronchial lung biopsy. A subsequent PETCT of the chest revealed patchy FDG avid sub-segmental collapse, consolidation with air bronchogram in lingular segment. There were also bilateralpulmonary few sub-centimeter nodular lesions andleft pleural thickening. However the primary breast lesion was not FDG avid. The diagnosis was made by lymph node biopsy of recently appearing supra-clavicular lymph node. The primary lesion was detected by clinical breast examination and confirmed by USG guided FNAC.