Primary Lung Adenocarcinoma Manifesting as Bilateral Reticulonodular Infiltrates: A Case Report.

Abstract

A 52-year-old female with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and supraventricular tachycardia (SVT) status postablation presented with progressive dyspnea and diffuse bilateral infiltrates on imaging. Symptoms began following exposure to a chicken farm, initially as a dry cough, evolving despite treatment with antibiotics, albuterol, and methylprednisolone. Emergency department CT imaging demonstrated bilateral linear, reticular, and nodular infiltrates. A negative infectious workup prompted bronchoscopy, confirming lung adenocarcinoma via immunohistochemical staining despite no significant smoking history, international travel, or other exposures. Brain MRI identified a solitary 7-mm enhancing lesion, guiding subsequent oncologic management. This case underscores the complexity of diagnosing atypical pulmonary symptoms and advocates for early bronchoscopic evaluation in suspected malignancies, particularly with pertinent family history.