ArticleFrontiers in medicine2026
Staged traditional Chinese medicine treatment for suspected pulmonary inflammatory pseudotumor with progressive lesion reduction: a case report and literature review.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pulmonary inflammatory pseudotumor (PIPT) is a rare benign lesion often indistinguishable from malignancy on imaging. For indeterminate solid masses exceeding 3 cm, surgical resection is generally recommended. Conservative management strategies for patients who decline surgery remain poorly defined. Case presentation: A 55-year-old male presented with a 3.4 cm × 2.6 cm irregular mass in the right lower lobe with lobulation and small bubble signs. CT-guided percutaneous biopsy revealed fibrous tissue proliferation with lymphoplasmacytic infiltration and epithelioid granulomas without necrosis. Immunohistochemistry showed TTF-1 (+), NapsinA (+), P40 (focally +), P53 (wild-type pattern), CEA (-), Ki67 (∼10%), KP-1 (+), CD38 (+), IgG (+), and IgG4 (focally +); special stains were negative. An inflammatory process consistent with PIPT was suspected; however, ALK, SMA, and Vimentin were not tested, and definitive distinction from pulmonary inflammatory myofibroblastic tumor (PIMT) could not be established. The patient declined surgery and received staged traditional Chinese medicine (TCM) treatment: early-phase therapy focused on dispersing wind and ventilating the lung; subsequent phases transitioned to supplementing Qi (vital energy), resolving phlegm, and activating blood circulation. Serial CT (same institution/scanner) demonstrated progressive lesion reduction to 2.5 cm × 1.8 cm at 5 months and 1.9 cm × 0.7 cm at 10 months, with corresponding symptomatic improvement. Conclusion: Spontaneous regression cannot be excluded. However, the absence of corticosteroid use, the pre-treatment stability of the lesion, and the stepwise reduction observed during successive treatment phases are temporally consistent with a treatment-associated response. Staged TCM syndrome differentiation may warrant further investigation as a conservative option for selected patients with inflammatory pulmonary lesions who decline surgery.
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