Pulmonary Multiloculated 'Lotus Torus-like' Sarcoidosis Mimicking Lung Adenocarcinoma

Intern Med. 2019 Feb 1;58(3):419-422. doi: 10.2169/internalmedicine.1541-18. Epub 2018 Sep 12.

Abstract

A 34-year-old Japanese woman exhibited a 35×25-mm solitary multiloculated mass shadow in the left lower lobe mimicking lung adenocarcinoma. On computed tomography, the mass resembled a lotus torus. A transbronchial lung biopsy and mediastinal lymph node biopsy led to the diagnosis of sarcoidosis. This lotus torus-like mass regressed spontaneously. This is the second reported case of pulmonary cavitary sarcoidosis with a 'lotus torus-like' appearance. We propose several findings regarding the lotus torus-like appearance by comparing the findings to those of lung adenocarcinoma. Knowledge of this unique sign may be helpful for the differential diagnosis of pulmonary sarcoidosis from lung adenocarcinoma.

Keywords: adenocarcinoma; cavitary; lotus; multiloculated; nodular; sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma of Lung / diagnosis
  • Adult
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Humans
  • Lotus
  • Lung Neoplasms / diagnosis
  • Sarcoidosis, Pulmonary / diagnosis*
  • Sarcoidosis, Pulmonary / pathology
  • Tomography, X-Ray Computed / methods