{
  "abstract": "Rationale:: Cavitary lung cancer, particularly squamous cell carcinoma (SCC), can closely mimic infectious cavitary diseases such as pulmonary aspergillosis. When molecular pathogen testing yields a positive result, the infectious diagnosis may be erroneously reinforced, and histological confirmation may be delayed.\n\nPatient concerns:: A 68-year-old male farmer with a 40 pack-year smoking history presented with a 6-month history of cough, expectoration, and chest tightness. Chest computed tomography revealed a 66 mm × 70 mm thick-walled cavitary lesion in the left upper lobe. Targeted next-generation sequencing of bronchoalveolar lavage fluid at the referring hospital detected Aspergillus flavus sequences, leading to a misdiagnosis of pulmonary aspergillosis and 2.5 months of voriconazole therapy, during which the lesion progressed.\n\nDiagnoses:: Repeat bronchoscopy at our institution revealed a fistulous opening with intracavitary nodules and necrotic material. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) at stations 4 L and 10 L confirmed poorly differentiated lung SCC. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) demonstrated hypermetabolism in the primary lesion, mediastinal lymph nodes, and sternum, supporting a clinical-radiological diagnosis of stage IVA (cT4N2M1b) disease.\n\nInterventions:: The patient received first-line paclitaxel plus carboplatin combined with tislelizumab for 6 cycles, followed by tislelizumab maintenance monotherapy.\n\nOutcomes:: A partial response according to the Response Evaluation Criteria in Solid Tumors version 1.1 was achieved after the first cycle, with sustained tumor shrinkage after 6 cycles and no evidence of disease progression during ongoing maintenance therapy.\n\nLessons:: In cavitary lung lesions, targeted next-generation sequencing detection of fungal sequences should not by itself override the need for histological evaluation, because molecular assays cannot distinguish colonization or contamination from invasive infection. Endobronchial ultrasound-guided transbronchial needle aspiration combined with positron emission tomography/computed tomography is valuable for diagnosis and staging when cavitary malignancy is suspected, and SCC remains an important subtype of cavitary lung cancer in long-term smokers.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Respiratory and Critical Care Medicine, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, Anhui, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ya Shen",
      "orcid": "0000-0002-7656-0245"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiao-Yu Cao"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing-Feng Shi"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiao-Bao Teng"
    },
    {
      "affs": [
        0
      ],
      "name": "Ming-Feng Han"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aq75764s5gbkm.bib",
  "cited_by": 0,
  "doi": "10.1097/md.0000000000051432",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727266/?tool=EBI",
  "id": "aq75764s5gbkm",
  "issns": [
    "0304-5412",
    "1536-5964",
    "0025-7974"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727266",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6700"
    ],
    [
      "heading",
      "Clinical Case Report"
    ],
    [
      "heading",
      "Research Article"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727266/pdf/?tool=EBI",
  "pmcid": "PMC13727266",
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/aq75764s5gbkm.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13727266",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727266"
    },
    {
      "first_seen": "2026-11-05T12:23:23Z",
      "native_id": "PMC13727266",
      "source": "pmc",
      "url": "https://doi.org/10.1097/md.0000000000051432"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Cavitary lung squamous cell carcinoma misdiagnosed as pulmonary aspergillosis following targeted next-generation sequencing : A case report",
  "title_text": "Cavitary lung squamous cell carcinoma misdiagnosed as pulmonary aspergillosis following targeted next-generation sequencing : A case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:59Z",
  "url": "https://research.draconitic.com/paper/aq75764s5gbkm",
  "venue": "Medicine",
  "versions": []
}