Lung Cancer: Lung Cancer: Diagnosis and Prognosis |

Multiple Radiolucencies and Cavities in Lung Adenocarcinoma: Radiological and Pathological Features FREE TO VIEW

Wenhui Chen
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Beijing Institute of Respiratory Medicine, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A273. doi:10.1016/j.chest.2016.02.285
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SESSION TITLE: Lung Cancer: Diagnosis and Prognosis

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Saturday, April 16, 2016 at 09:45 AM - 11:15 AM

PURPOSE: To evaluate clinical, radiological and pathological features of multiple radiolucencies and cavitation in lung adenocarcinoma

METHODS: A total of 845 lung adenocarcinomas cases with adequate imaging data were diagnosed in our hospital between August 2010 and August 2013. Among these cases, 29 cases (3.4%) were found having bilateral multiple radiolucencies and cavities (more than 2 leisions) within pulmonary abnormalities based on high-resolution computed tomography (HRCT) scans and were enrolled in our study. There were 17 females and 12 males ranging from 32 to 83 years of age. The characteristics of multiple cavities were evaluated, including wall thickness, contours, and presence of air-fluid levels and internal soft-tissue septa. The subtypes of adenocarcinoma, descriptions of necrosis, cavitation or cystic change, mucin production were determined.

RESULTS: Multiple cavities had 4 main types of different imaging appearances, including thick-walled cavities (n=8), circular cavities (n=21), thin-walled cavities or cystic cavities (n=8), cavities or multicystic changes within airspace consolidation or ground glass opacity (n=11). The presence of internal soft-tissue septa in cavity was commonly seen (58.6%, 17/29). Those septa existed in thick-walled cavities and thin-walled cavities, seldom existed in circular cavities. Some internal septa may be like spoke sign (n=1), some may be like small vessels intruded from the wall to the inner cavity (n=6). Cavitary lesions often companied by pulmonary nodules and ground glass nodules (82.8%, 24/29). All cases were invasive adenocarcinomas (n=23) or variants of invasive adenocarcinomas (n=6). Cavities or radiolucencies within consolidation or ground glass opacity were found in all 6 invasive mucinous adenocarcinomas. Circular cavities were seen in all 4 cases of papillary adenocarcinomas.

CONCLUSIONS: Multiple radiolucencies and cavities in lung adenocarcinoma had an extraordinary polymorphism and the mechanism was heterogeneous.

CLINICAL IMPLICATIONS: Most of lung adenocarcinama are not resectable at the point of diagnosis, late-stage patients may benefit from an imaging-based adenocarcinoma subtyping approach. So getting CT characteristics and histological subtypes of multiple radiolucencies and cavities in lung adenocarcinoma is very important in palliative settings. This may benefit the diagnosis and following treatment of lung adenocarcinoma.

DISCLOSURE: The following authors have nothing to disclose: Wenhui Chen

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