case_images: PMC10905053_01
case_images: HRCT chest findings. A) Lung window in axial section shows left upper lobe fibro-cavity with intracavitary mass (blue arrow) with shaggy cavitary wall and bronchiectasis in atelectatic segments (orange arrow).. B) Lung window in coronal section shows air crescent sign (yellow arrow) and bilateral diffuse ground glass opacities.. C) Sagittal section shows parenchymal infiltrates (green arrow) and pleural thickening adjacent to the cavity (red arrow).. D) Mediastinal window reveals mixed attenuating soft tissue density with an air crescent sign in the left upper lobe (yellow arrow).
case_images: cureus-0016-00000053256-i01.jpg
case_images: PMC10905053_01_cureus-0016-00000053256-i01.jpg
case_images: FIG1
case_images: An HRCT chest revealed a left upper lobe cavity with an intracavitary mass demonstrating 'air-crescent' sign, parenchymal destruction with peri-broncho-vascular interstitial thickening, dilated bronchi/bronchioles with ipsilateral lung volume reduction along with ground glass opacities, and adjacent pleural thickening (Figure 1).
case_images: Post-operative chest radiograph. Chest X-ray showing adequate left lung expansion following upper lobectomy.
case_images: cureus-0016-00000053256-i02.jpg
case_images: PMC10905053_01_cureus-0016-00000053256-i02.jpg
case_images: FIG2
case_images: Chest radiography revealed adequate residual lung expansion following left upper lobectomy (Figure 2).
case_images: Histopathology of the surgical specimen. Figure 3A shows a low-power image of the resected specimen demonstrating destroyed bronchial mucosa (blue arrow) with Aspergillus invasion (orange arrow). Figure 3B shows a high-power image of a resected specimen showing extensive monomorphic lymphoid infiltrate in the bronchial wall (white arrows), suggesting lymphoid proliferation.
case_images: cureus-0016-00000053256-i03.jpg
case_images: PMC10905053_01_cureus-0016-00000053256-i03.jpg
case_images: FIG3
case_images: Histopathological examination of the resected lobe showed a markedly dilated and destroyed bronchial wall with septate hyphae invading the bronchial wall and peri-bronchial interstitium (Figure 3A). HPE also demonstrated peculiar, dense, diffuse infiltration of monomorphic neoplastic lymphocyte aggregates (Figure 3B) that were positive for both T cell and B cell markers with a Ki-67 proliferation index of 2%-4%, suggesting MALToma (Table 1).
case_images: PET-CT scan (post-lobectomy). A) Axial section showing uptake in the surgical area (SUV max: 3.2). B) Axial section showing uptakes in subcarinal node and left ribs
case_images: cureus-0016-00000053256-i04.jpg
case_images: PMC10905053_01_cureus-0016-00000053256-i04.jpg
case_images: FIG4