LAUSR

An 81-year-old former smoker, with a history of asthma and surgical treatment of abdominal aortic aneurysm, was admitted to hospital with a 1-month history of fever up to 38.6°C, purulent sputum and left-sided pleuritic chest pain. Chest computed tomography (CT) showed consolidation type infiltrates peripherally in both lungs. Flexible bronchoscopy revealed no endobronchial lesion and cytological and microbiological examination, as well as qualitative analysis of bronchoalveolar lavage (BAL) were non-diagnostic. The cytological examination of BAL revealed: macrophages 85%; lymphocytes 12%; eosinophils 2%; and other neutrophils 1%. Investigations for IgG4-related disease or any other autoimmune disorder were negative. The patient was treated with amoxicillin–clavulanic acid for 10 days before admission. He was treated with ciprofloxacin–clindamycin on admission, but due to clinical and radiological deterioration on chest CT, we administered wide-spectrum antibiotics (meropenem plus vancomycin) without clinically significant response (figure 1). Inflammatory myofibroblastic tumour (IMT) is a rare neoplasm, most commonly described in children and young adults. We present a case of IMT in an elderly man. https://bit.ly/355wf8X