eFigure 33-30.

Noninfectious “nonresponding” pneumonia: invasive mucinous adenocarcinoma (formerly referred to as mucinous bronchioloalveolar carcinoma).

A, Frontal chest radiograph in a patient with persistent shortness of breath shows right lower lobe consolidation. The patient was treated with broad-spectrum antibiotics for presumed community-acquired pneumonia. B, Repeat frontal chest radiograph 3 months following A shows no change in the appearance of the right lower lobe opacity. C, Axial chest CT through the right lung base shown in lung windows reveals relatively nonspecific subpleural consolidation with air bronchograms and reticulation associated with ground-glass opacity. D, Fused FDG-PET image shows the right lower lobe opacity to be hypermetabolic. Bronchoscopic evaluation did not disclose a specific diagnosis for the persistent right lower lobe opacity. Resection of the right lower lobe proved invasive mucinous adenocarcinoma.

(Courtesy Michael Gotway, MD.)