TY - JOUR T1 - Pulmonary malakoplakia: a rare presentation mimicking extensive stage IV lung cancer JF - European Respiratory Journal JO - Eur Respir J SP - 983 LP - 985 DO - 10.1183/09031936.00002911 VL - 38 IS - 4 AU - P. Mandal AU - W.A. Wallace AU - K.M. Skwarski Y1 - 2011/10/01 UR - http://erj.ersjournals.com/content/38/4/983.abstract N2 - To the Editors:Herein, we report a 74-yr-old female who presented with several weeks history of persistent cough productive of mucoid phlegm with specks of haemoptysis. This was associated with fatigue and poor appetite. She also reported a minor episode of nosebleed. She denied any shortness of breath, chest pain, weight loss or any alteration of bowel habit. She complained of some intermittent left-sided pleuritic-type chest pain, which prompted a chest radiograph and urgent referral to the chest clinic thereafter.Her past medical history included left breast surgery 11 yrs ago for ductal carcinoma in situ, atrial fibrillation, essential hypertension, sciatica and psoriasis. She was an ex-smoker with a 37-pack-yr history.Initial blood tests showed a haemoglobin level of 107 g·L−1, a white cell count of 18.6×109 cells·L−1 (lymphocyte count 1.89×109 cells·L−1) and a platelet count of 128×109 cells·L−1. Liver function tests were normal and she was HIV negative.A chest radiograph revealed the presence of a posteriorly located left lower lobe mass. A computed tomography (CT) scan (fig. 1) confirmed the presence of a pleural-based mass posteriorly in the left lower lobe measuring 3.7×3.2 cm with spiculated margin in contiguity with the dome of the left hemidiaphragm and extending into the abdomen. The mass appeared to be infiltrating the … ER -