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Updated: Aug 8, 2026
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
[An intra-pulmonary lymphnode resembling typical pulmonary primary adenocarcinoma on high-resolution computed
Rieko Hatta1, Yoshihiro Nambu, Yoshimasa Maebou
1Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa, Japan.
Insights
Pulmonary nodules with specific imaging features can be mistaken for lung cancer. This case highlights that intrapulmonary lymph nodes can mimic primary pulmonary adenocarcinoma on chest imaging.
Area of Science:
- Pulmonology
- Radiology
- Pathology
Background:
- Pulmonary nodules detected on chest imaging require careful evaluation to differentiate benign from malignant lesions.
- Radiographic findings like spiculation, pleural indentation, and converging vessels are often associated with primary pulmonary adenocarcinoma.
Observation:
- An 8-mm pulmonary nodule in the right anterior basal lobe presented with spiculation, pleural indentation, and converging vessels on high-resolution computed tomography.
- These imaging characteristics were highly suggestive of primary pulmonary adenocarcinoma.
Findings:
- Video-assisted thoracoscopic surgery (VATS) was performed for diagnosis.
- Histopathological examination revealed the nodule to be an intrapulmonary lymph node, not primary pulmonary adenocarcinoma.
Implications:
- Radiologists and clinicians should consider intrapulmonary lymph nodes in the differential diagnosis of pulmonary nodules with suspicious imaging features.
- Accurate differentiation is crucial to avoid unnecessary invasive procedures and ensure appropriate patient management.
Abstract:
A 40-year-old man was admitted to our hospital for further evaluation of a pulmonary nodule in chest radiographs. The 8-mm nodular lesion was located in the right anterior basal lobe on a plain chest radiograph, and showed 1) spiculation, 2) pleural indentation and 3) a converging vessel formation in high-resolution computed tomography of the chest. The radiographic findings were highly suggestive of primary pulmonary adenocarcinoma and the patient underwent video-assisted thoracoscopic surgery (VATS) to obtain a precise diagnosis. The nodule was diagnosed histopathologically as an intrapulmonary lymph node. In cases with such radiographic findings, careful attention should be paid in the differential diagnosis to distinguish intrapulmonary lymph nodes from primary pulmonary adenocarcinoma.
