Atypical lung feature on chest CT in a lung adenocarcinoma cancer patient infected with COVID-19.

Coronavirus disease 2019 (COVID-19)1,2 is currently a major medical issue, and several studies have reported the typical lung features of the disease on chest computed tomography (CT). We present manifestations of COVID-19 in a patient with lung adenocarcinoma.

In February 2020, a 46-year-old female patient presented with a growing palpable mass on the right parietal region with no any other symptoms or history. She initially visited the Second Hospital of Luohe City on February 4 2020, and was examined by one physician who was diagnosed with COVID-10 on 5 February 2020 (day 1, was in contact with the infected patient). The diagnosis of lung adenocarcinoma was confirmed by bronchoscopic biopsy, and the mass on the right parietal region was considered metastatic. The patient was transferred to Henan Chest Hospital for further treatment on 9 February 2020 (day 5). Henan Chest Hospital was informed that this patient had been in contact with the diagnosed infected physician on 14 February 2020, and she immediately had chest CT and RT-PCR tests for COVID-19 nucleic acid using nasopharyngeal swabs. Results of RT-PCR testing for COVID-19 nucleic acid were positive on 14 February 2020 (day 10), however, chest CT did not demonstrate typical reported signs of COVID-19. The patient subsequently developed intermittent fever to 38°C on the morning of 15 February 2020, and was transferred to the Sixth People Hospital of Zhengzhou, which is a designated hospital for COVID-19. The patient experienced intermittent chest tightness, nausea, and vomiting, and she received treatment with traditional Chinese medicine. Chest CT scanning was carried out again on 18 February 2020 (day 14), and no typical CT features for COVID-19 were found. RT-PCR tests for COVID-19 were repeated on 18 February (day 14) and 20 February (day 16) 2020, and both were negative. She had increased C-reactive protein levels and reduced lymphocyte ratios (Table 1). Her symptoms started to improve, and she was transferred to a general ward.


Author: Jinrong Qu, Rui Yang, Liucun Song, et al.