A 63-year-old male with a 45 pack-year smoking history and COPD presents with progressive cough, unintentional weight loss, and acute confusion. Vital signs show BP 138/82, HR 102, RR 22, SpO2 92% on room air, and temperature 37.2°C. Chest CT reveals a centrally located 4-cm hilar mass. Serum sodium is 121 mEq/L; glucose and renal function are normal. He denies hemoptysis. He takes albuterol and tiotropium regularly. Which of the following is the most likely diagnosis?
- A)Bronchiectasis
- B)Small cell lung carcinomaGABARITO
- C)Pulmonary adenocarcinoma
- D)Mesothelioma
- E)Pulmonary hamartoma
Explicação
Small cell lung carcinoma is correct. Small cell carcinoma is a central neuroendocrine tumor strongly associated with smoking and is well known for paraneoplastic secretion of antidiuretic hormone, causing hyponatremia and confusion. A central hilar mass in a ... Ver explicação completa e trilha adaptativa →