PULMONARY INFECTIONS MIMICKING CANCER - A RETROSPECTIVE, 3-YEAR REVIEW

Pulmonary infections can mimic or occasionally co-exist with pulmonary neoplasms. In order to determine the frequency and nature of these in fections, we conducted a retrospective analysis, covering a 3-year per iod, of patients who were referred to our center with presumed lung ca ncer but turned out to have pulmonary infection instead. The overwhelm ing majority of patients (93.3%) referred to ''rule out'' lung cancer were documented as having a neoplastic process, and only 1.3% had an i nfection. Fungal infections (histoplasmosis, cryptococcosis, coccidiom ycosis) accounted for 46%, mycobacteria for 27%, bacteria for 22%, and parasitic lesions (dirofilariasis) for 5% of these infections. The mo st common clinical manifestations were cough and chest pain, and the m ost common radiographic finding was a solitary pulmonary nodule. There were no specific clinical or radiographic features predictive of eith er infection or neoplastic disease. All patients responded to specific anti-infective therapy with or without surgical excision. Our data in dicate that pulmonary infections mimic neoplasms very infrequently. Ho wever, establishing a specific diagnosis is critical, since the manage ment and outcome of these two processes are entirely different.