A. Cancer
Considering the constellation of symptoms presented by the 65-year-old
male patient, along with radiological findings and relevant history, the
probability of lung cancer must be carefully assessed. The patient’s
chief complaints include hemoptysis, fever, pleuritic chest pain, and
weight loss. These symptoms, when observed together, raise significant
concern for an underlying malignancy, particularly lung cancer.
Hemoptysis, although not pathognomonic for lung cancer, is a concerning
symptom often associated with malignancies of the lung parenchyma (9).
The LCTA revealed consolidations in the pulmonary parenchyma.
Consolidations, especially when multifocal or persistent, are concerning
for neoplastic processes such as lung cancer (10). While consolidations
can be seen in various pulmonary conditions, including infectious
etiologies like pneumonia, the presence of consolidations in conjunction
with the patient’s symptoms and history warrants thorough investigation
for malignancy.
Of significant relevance is the patient’s history of cigarette smoking.
Cigarette smoking is the most significant risk factor for the
development of lung cancer, accounting for most cases.
Considering the patient’s presentation of hemoptysis, fever, pleuritic
chest pain, weight loss, consolidations on imaging, and a history of
cigarette smoking, the probability of lung cancer is notably elevated.
There are two primary types of lung cancer: non-small cell lung cancer
(NSCLC) and small cell lung cancer (SCLC) (11). NSCLC is further
categorized into three subtypes: adenocarcinoma, squamous cell
carcinoma, and large cell carcinoma (12). Adenocarcinoma is the most
common form of lung cancer, particularly among smokers (12). It tends to
occur in the outer regions of the lungs and is associated with a higher
incidence in individuals with a history of smoking. Adenocarcinoma often
presents with symptoms such as hemoptysis, cough, and weight loss (13).
B. Infectious diseases
Considering the clinical presentation, radiological findings, and
regional epidemiology, the probability of infectious diseases such as
tuberculosis (TB) and aspergillosis must be carefully considered.