Atypical pulmonary manifestations suggestive of lung cancer in behçet's disease with spontaneously regressing lymphadenopathy and a lung mass: a case report

Behçet's disease (BD) is a multisystem inflammatory disorder that can affect various organs, including the lungs. Pulmonary manifestations are rare and typically present as pulmonary artery aneurysms. We report the case of a 56-year-old East Asian male with a 27-year history of BD, who had no respiratory symptoms, such as hemoptysis, cough, or fever. Chest imaging revealed lymph node enlargement and a lung mass, initially raising concerns of malignancy. Despite the suspicious radiological findings, three biopsies, including a surgical biopsy, were all negative for malignancy. Remarkably, over the course of 2 years, these pulmonary manifestations spontaneously regressed without any specific treatment for lung involvement, and the patient remained in a stable BD state. BD patients are at an increased risk for malignancy compared to healthy controls, making it crucial to differentiate between malignancy and BD-related pulmonary abnormalities. This case highlights that, in the absence of active BD symptoms, lymphadenopathy and lung masses can occur and may resolve spontaneously. Accurate diagnosis and vigilant monitoring are essential in BD patients but BD-related lung involvement should be considered in similar cases.