Suspicious right lower-lobe lung nodule reclassified as benign lipoid pneumonia after VATS wedge resection

What happened, in summary

This 41-year-old woman had a persistent ground-glass opacity in the right lower lobe of the lung that had been detected 4 years earlier. The lesion had a cystic component and initially remained stable in size. Over time, however, follow-up CT showed increasing density, which raised concern for an indolent lung adenocarcinoma. Because ground-glass nodules with increasing density can represent early lung cancer, her team proceeded with surgical diagnosis and treatment. On 24 July 2024, she underwent single-port video-assisted thoracoscopic wedge resection of the suspicious right lower-lobe lesion. The final pathology was reassuring and changed the clinical picture. Instead of lung cancer, the resected tissue showed extensive lymphocyte infiltration in the subpleural alveolar septa, foamy macrophage-like cells, a small amount of cholesterol crystal deposition in some alveolar spaces, and mild hyperplasia of the alveolar epithelium. These findings supported lipoid pneumonia of the right lower lobe, a benign inflammatory condition that can mimic lung cancer on imaging. No malignant lung tumor was confirmed. This case is best understood as a cancer-mimic story: imaging was suspicious enough to justify surgery, but pathology showed non-cancer inflammation. Long-term follow-up information was not available. For the library, the most accurate outcome is no confirmed cancer after resection, with the important caveat that the surgery was performed because the lesion behaved like a possible early adenocarcinoma. It highlights why tissue diagnosis remains important when lung nodules evolve slowly over years. The clinical record therefore ends with a benign diagnosis rather than an oncologic treatment course requiring ongoing cancer therapy.