AI Article Synopsis
- A 42-year-old man was diagnosed with dermatomyositis (DM) after experiencing retrosternal pain, skin rashes, and muscle weakness, with subsequent muscle enzyme and electromyography tests confirming the condition.
- Despite initial treatment with prednisone leading to clinical improvement, a chest CT revealed squamous cell lung cancer with metastases, which had been missed in an earlier scan.
- The case emphasizes the need for careful evaluation for underlying conditions like lung cancer and pulmonary tuberculosis in patients with DM, particularly in areas where TB is prevalent.
Article Abstract
A 42-year-old man with four months of retrosternal pain and two months of skin rashes and proximal muscle weakness was diagnosed with dermatomyositis (DM) based on muscle enzyme analysis and needle electromyography. Chest computed tomography (CT) showed scattered inflammation nodules in both lungs' upper lobes with negative sputum smear for lung cancer and pulmonary tuberculosis (TB). A good clinical response to oral prednisone was obtained, except for the retrosternal pain in the preceding two months. Urgent CT pulmonary angiography ruled out pulmonary thromboembolism but revealed squamous cell lung cancer with metastases in the sternum and mediastinal lymph nodes. In retrospect, we found osteolytic destruction consistent with sternal metastasis on CT taken at the initial treatment of DM, which was missed by radiologists. Simultaneously, the man was diagnosed with pulmonary TB based on rapid mycobacterial TB detection. This case report indicates the radiologic errors and highlights the importance of a thorough search for underlying lung cancer and pulmonary TB in patients with DM, especially in countries with a high TB burden.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898925 | PMC |
| http://dx.doi.org/10.1515/med-2022-0451 | DOI Listing |
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