Right Angle, Wrong Assumptions: A Case of Endobronchial Mucormycosis Presenting as a Pedunculated Mass Mimicking Malignancy
5 affiliations
- 1Department of Pulmonology and Sleep Medicine Lahore General Hospital Lahore Punjab Pakistan.
- 2Ameer-Ud-Din Medical College, PGMI, Lahore General Hospital Lahore Punjab Pakistan.
- 3Department of Histopathology Lahore General Hospital Lahore Punjab Pakistan.
- 4King Edward Medical University Lahore Punjab Pakistan.
- 5S Tentishev Asian Medical Institute Kant Kyrgyzstan.
Abstract
Pulmonary mucormycosis is an aggressive, angioinvasive fungal infection that carries high mortality. Endobronchial involvement is rare and may present as a pedunculated mass with associated parenchymal consolidation, mimicking lung cancer. We present a case of a 52-year-old male smoker with poorly controlled Type 2 diabetes mellitus, chronic obstructive pulmonary disease (COPD) and a history of pulmonary tuberculosis 19 years prior presented with a 6-month history of cough and hemoptysis. Suspecting tuberculosis reactivation, he was empirically treated with anti-tuberculosis therapy (ATT) for 6 months without clinical response. High-Resolution Computed Tomography (HRCT) of the chest revealed a 4.9 cm hyperdense necrotic consolidation patch with internal calcification in the right upper lobe (RUL). Flexible video-bronchoscopy demonstrated a pedunculated mass in the posterior segment of the RUL, clinically concerning for lung cancer. Biopsy of tissue revealed extensive necrosis, hyalinization and thick-walled, broad, non-septate fungal hyphae with characteristic right-angle branching and spores, confirming pulmonary mucormycosis without evidence of malignancy or granulomatous disease. Endobronchial mucormycosis should be considered in patients with diabetes, chronic airway disease or post-tuberculosis lung disease who present with non-resolving endobronchial masses. Early bronchoscopic tissue sampling is essential to avoid delayed diagnosis and inappropriate empirical therapy.
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BibTeX
@article{abbas2026right,
title = {{Right Angle, Wrong Assumptions: A Case of Endobronchial Mucormycosis Presenting as a Pedunculated Mass Mimicking Malignancy}},
author = {Rabbia Abbas and Ali Gohar and Hafiz Muhammad Faisal Nadeem and Memoona Anees and Nida Nazar and Muhammad Umais and Muhammad Husnain Ahmad},
journal = {Respirology case reports},
year = {2026},
month = oct,
doi = {10.1002/rcr2.70803},
url = {https://europepmc.org/article/PMC/PMC13716929},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Right Angle, Wrong Assumptions: A Case of Endobronchial Mucormycosis Presenting as a Pedunculated Mass Mimicking Malignancy
AU - Rabbia Abbas
AU - Ali Gohar
AU - Hafiz Muhammad Faisal Nadeem
AU - Memoona Anees
AU - Nida Nazar
AU - Muhammad Umais
AU - Muhammad Husnain Ahmad
PY - 2026
DA - 2026/10/28
JO - Respirology case reports
DO - 10.1002/rcr2.70803
UR - https://europepmc.org/article/PMC/PMC13716929
AB - Pulmonary mucormycosis is an aggressive, angioinvasive fungal infection that carries high mortality. Endobronchial involvement is rare and may present as a pedunculated mass with associated parenchymal consolidation, mimicking lung cancer. We present a case of a 52-year-old male smoker with poorly controlled Type 2 diabetes mellitus, chronic obstructive pulmonary disease (COPD) and a history of pulmonary tuberculosis 19 years prior presented with a 6-month history of cough and hemoptysis. Suspecting tuberculosis reactivation, he was empirically treated with anti-tuberculosis therapy (ATT) for 6 months without clinical response. High-Resolution Computed Tomography (HRCT) of the chest revealed a 4.9 cm hyperdense necrotic consolidation patch with internal calcification in the right upper lobe (RUL). Flexible video-bronchoscopy demonstrated a pedunculated mass in the posterior segment of the RUL, clinically concerning for lung cancer. Biopsy of tissue revealed extensive necrosis, hyalinization and thick-walled, broad, non-septate fungal hyphae with characteristic right-angle branching and spores, confirming pulmonary mucormycosis without evidence of malignancy or granulomatous disease. Endobronchial mucormycosis should be considered in patients with diabetes, chronic airway disease or post-tuberculosis lung disease who present with non-resolving endobronchial masses. Early bronchoscopic tissue sampling is essential to avoid delayed diagnosis and inappropriate empirical therapy.
SN - 2051-3380
ER -