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A man had a persistent cough and asked an AI (information platform) which suggested pneumonia or asthma. A doctor diagnosed him with lung cancer. Multiple cases were treated within a month.
July 3, 2026, 08:00,
Xiao Zhao, 30, is a programmer. Although he doesn't smoke or drink, he is under a lot of work pressure and often stays up late.
Three months ago, he caught a cold with fever, cough, and yellow phlegm. He went to the local hospital for a chest CT scan, which showed a shadow of "pneumonia" in his lower left lung. So, he received intravenous treatment at the outpatient clinic for 5 days.
The fever subsided, but the cough and phlegm remained significant. The doctor recommended hospitalization for further examination and performed a bronchoscopy. The bronchoscopy revealed inflammatory changes in the bronchial mucosa, and bronchoalveolar lavage fluid microbial gene sequencing indicated "Haemophilus influenzae infection," one of the most common pathogens of community-acquired pneumonia.
After a week of intensive anti-infection treatment, Xiao Zhao's sputum turned from yellow to white, but his cough remained persistent. Due to his busy work schedule, he hurriedly left the hospital with his medication. The doctor instructed him to have a follow-up chest CT scan in four weeks, but Xiao Zhao felt that the CT scan involved radiation and did not take it seriously.
After being discharged from the hospital, the cough persisted. Having had a slight lingering concern, he sent all his previous test results to the AI. The AI told him that Haemophilus influenzae is a common and typical culprit in pneumonia, accounting for a high percentage. It seemed there wasn't anything seriously wrong, and he felt relieved.
After coughing for three months, the hospital diagnosed him with lung cancer.
Pneumonia-type lung cancer that is good at disguising itself
Even with a bronchoscope, it is difficult to see.[/COLOR][/COLOR]
July 3, 2026, 08:00,
Xiao Zhao, 30, is a programmer. Although he doesn't smoke or drink, he is under a lot of work pressure and often stays up late.
Three months ago, he caught a cold with fever, cough, and yellow phlegm. He went to the local hospital for a chest CT scan, which showed a shadow of "pneumonia" in his lower left lung. So, he received intravenous treatment at the outpatient clinic for 5 days.
The fever subsided, but the cough and phlegm remained significant. The doctor recommended hospitalization for further examination and performed a bronchoscopy. The bronchoscopy revealed inflammatory changes in the bronchial mucosa, and bronchoalveolar lavage fluid microbial gene sequencing indicated "Haemophilus influenzae infection," one of the most common pathogens of community-acquired pneumonia.
After a week of intensive anti-infection treatment, Xiao Zhao's sputum turned from yellow to white, but his cough remained persistent. Due to his busy work schedule, he hurriedly left the hospital with his medication. The doctor instructed him to have a follow-up chest CT scan in four weeks, but Xiao Zhao felt that the CT scan involved radiation and did not take it seriously.
After being discharged from the hospital, the cough persisted. Having had a slight lingering concern, he sent all his previous test results to the AI. The AI told him that Haemophilus influenzae is a common and typical culprit in pneumonia, accounting for a high percentage. It seemed there wasn't anything seriously wrong, and he felt relieved.
After coughing for three months, the hospital diagnosed him with lung cancer.
However, over the past three months, Xiao Zhao's cough has not only failed to improve, but has gradually worsened. He coughs up large amounts of thin, watery phlegm, and often breaks out in a cold sweat, accompanied by chest tightness and shortness of breath.
He turned to AI again, and the AI analysis said, "Asthma needs to be ruled out." So, accompanied by his wife, he went to the clinic of Jin Qian, director of the Department of Respiratory and Critical Care Medicine at Zhejiang Provincial Tongde Hospital, and asked to rule out asthma.
After taking a detailed medical history and conducting a physical examination, Jin Qian determined that Xiao Zhao's symptoms did not match those of asthma and suggested a repeat chest CT scan. Xiao Zhao remained hesitant, concerned about radiation. After repeated persuasion from the doctor, he finally underwent a low-dose spiral CT scan. The results showed that the "inflammation" in his lower left lung had not only failed to resolve but had actually progressed significantly.
Jin Qian advised him to be hospitalized immediately for further examination, but Xiao Zhao was very resistant, even complaining that the doctor who had treated him before hadn't cured his pneumonia. Jin Qian patiently explained: "If the pneumonia doesn't improve after routine anti-infective treatment, we need to rule out several possibilities: infection with special pathogens (such as fungi or tuberculosis), organizing pneumonia caused by autoimmune diseases, and some malignant diseases, such as pneumonia-type lung cancer or lymphoma. Based on your CT images and medical history, pneumonia-type lung cancer is a key area that must be investigated."
Xiao Zhao ultimately followed the advice. After being hospitalized, tests revealed a significantly elevated level of carcinoembryonic antigen (CEA) in his blood, and a lung biopsy ultimately diagnosed him with invasive mucinous adenocarcinoma of the lung. Fortunately, genetic testing showed a gene mutation, meaning he could receive comprehensive treatment, including oral targeted therapy.
Pneumonia-type lung cancer that is good at disguising itself
Xiao Zhao is the third young patient diagnosed with pneumonia-type lung cancer in Jinqian in the past month.
This type of lung cancer is extremely adept at disguising itself, and its pathological type is mostly invasive mucinous adenocarcinoma of the lung. As the name suggests, these cancer cells secrete a large amount of mucus, so clinically, patients often cough up large amounts of thin white or clear sputum, with the daily sputum volume reaching more than 100 ml, and in severe cases even exceeding 1000 ml.
These cancer cells creep along the alveolar walls, forming diffuse lesions and lung tissue consolidation. On CT images, they appear as patchy shadows with blurred borders, which at first glance look exactly like ordinary pneumonia. This is why they often "deceive the authorities".
In fact, the local doctor had already given the correct advice: a follow-up CT scan in four weeks. Like many others, Xiao Zhao missed this crucial warning window because of his fear of radiation. Indeed, after being diagnosed with pneumonia, the doctor recommended a follow-up chest CT scan in about four weeks precisely to promptly identify hidden diseases disguised as pneumonia.
Even with a bronchoscope, it is difficult to see.[/COLOR][/COLOR]
Many people might think: Xiao Zhao has been very cooperative, even having a bronchoscopy done, so why wasn't the lung cancer detected earlier?
In fact, this is another "cunning" aspect of pneumonia-type lung cancer—its appearance under bronchoscopy can be merely nonspecific congestion and edema of the bronchial mucosa, almost indistinguishable from ordinary inflammation. Moreover, the bronchoscopy lens can only reach the larger bronchial branches, while the lesions often hide in the more distant alveolar regions, making them difficult to see directly. Unless the doctor specifically sends bronchoalveolar lavage fluid or tissue for pathological examination beforehand, it is possible to detect a small portion of these "latent" pneumonia-type lung cancers.
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