https://doi.org/10.4081/monaldi.2017.864

Middle lobe syndrome: An exceptional presentation of concomitant lepidic adenocarcinoma and bronchial anthracofibrosis

Vol. 87 No. 3 (2017)
Submitted: June 5, 2017
Accepted: November 5, 2017
Published: December 19, 2017
Biomass fuel smoke exposure, bronchial anthracofibrosis, lepidic adenocarcinoma, fibreoptic bronchoscopy, high resolution computed tomography.
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Authors

Shekhar Kunal
University of Delhi, Department of Pulmonary Medicine, India.
Sudhir Jain
Nayati Medicity, Department of Pathology, India.
Ashok Shah
ashokshah99@yahoo.com
University of Delhi, Department of Pulmonary Medicine, India.

Lepidic adenocarcinoma previously known as bronchioloalveolar carcinoma (BAC) is a non-small cell lung cancer with an indolent presentation. Bronchial anthracofibrosis (BAF) is caused by long-standing exposure to biomass fuel smoke often in poorly ventilated kitchen. Middle lobe syndrome (MLS) due to BAF is not uncommon however, lepidic adenocarcinoma then known as BAC, presenting as MLS has been documented only once before in the Polish literature. A 68-year-old never-smoker female with biomass fuel smoke exposure presented with cough and breathlessness. Imaging revealed MLS. Fiberoptic bronchoscopy visualised bluish-black hyperpigmentation with narrowing and distortion of right middle lobe bronchus suggestive of BAF. Transbronchial biopsy confirmed presence of lepidic adenocarcinoma. To our knowledge, this is the first detailed description of lepidic adenocarcinoma and BAF presenting as MLS. 

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Supporting Agencies

None
Shekhar Kunal, University of Delhi, Department of Pulmonary Medicine

Junior Resident,
Department of Pulmonary Medicine

Sudhir Jain, Nayati Medicity, Department of Pathology

Senior Consultant Pathologist

Department of Pathology

Ashok Shah, University of Delhi, Department of Pulmonary Medicine

Director Professor,
Department of Pulmonary Medicine

How to Cite

Kunal, Shekhar, Sudhir Jain, and Ashok Shah. 2017. “Middle Lobe Syndrome: An Exceptional Presentation of Concomitant Lepidic Adenocarcinoma and Bronchial Anthracofibrosis”. Monaldi Archives for Chest Disease 87 (3). https://doi.org/10.4081/monaldi.2017.864.

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