Pulmonary Mass as a Rare Pulmonary Manifestation of Inflammatory Bowel Disease

Pulmonary involvement in inflammatory bowel disease (IBD) is rare, particularly as parenchymal lesions such as masses. We report a 42-year-old woman with recently diagnosed Crohn's disease, not on active treatment, who presented with pleuritic chest pain and dyspnea. Imaging revealed a right-sided pulmonary mass in contact with the pleura and diaphragm. Initial workup excluded pulmonary embolism and infection. Bronchoalveolar lavage showed lymphocytic inflammation with negative microbiology, and autoimmune studies were unremarkable. PET-CT demonstrated no metabolic activity. Histological examination of a biopsy revealed non-necrotising granulomas with eosinophilic infiltration, without evidence of malignancy or infection. Based on exclusion and clinical context, a diagnosis of pulmonary manifestation of IBD was established. Corticosteroid therapy led to rapid clinical and radiological improvement. This case highlights the importance of considering IBD-related pulmonary disease in the differential diagnosis of lung masses to avoid misdiagnosis and ensure appropriate treatment.