{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:23:33Z","timestamp":1787207013004,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC1712901"],"award-info":[{"award-number":["2021YFC1712901"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 55-year-old male presented with a 3.4 cm \u00d7 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 (\u2212), Ki67 (\u223c10%), 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 \u00d7 1.8 cm at 5 months and 1.9 cm \u00d7 0.7 cm at 10 months, with corresponding symptomatic improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1873013","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:26:16Z","timestamp":1787203576000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Staged traditional Chinese medicine treatment for suspected pulmonary inflammatory pseudotumor with progressive lesion reduction: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Saimei","family":"Nie","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Wangjing Hospital of China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Wangjing Hospital of China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Wangjing Hospital of China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"354","DOI":"10.6004\/jnccn.2025.0043","article-title":"NCCN guidelines(R) insights: non-small cell lung cancer. 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