Learning objectives
To recognize features of early lung cancer associated with cystic lung parenchyma and to have regular surveillance.
Lung cancer pathogenesis associated with cystic airspaces.
Identify non-malignant processes that can mimic peri-cystic lung cancers
Background
Early lung cancers associated with cystic airspaces have been reported since the early 1940s [1]. In the recent times, these cancers have been increasingly recognized due to more screening trials and serial imaging being performed. These cancers have been commonly misinterpreted as inflammation or infection, delaying the diagnosis and therefore its management. Majority of the lung cancers associated with cystic spaces have been predominantly of the non-small cell adenocarcinoma type. In a recent retrospective study by Fintelmann et al, majority of these lung cancers have...
Imaging findings OR Procedure details
Current classification system for cancers associated with cystic airspaces are largely divided into four types (I-IV) [1]. This classification system does not provide any prognostic information but rather helps in risk stratification. The growth pattern of these early cystic lesions is quite variable with no stepwise transition between different types. It is important to have timely surveillance in order to check for progression. As noted in Fig 5 and 6 there has been a progression of the bubbly lesion in three years and it was...
Conclusion
Detecting early lung cancers associated with cystic airspaces due to the background chronic lung changes and are therefore easily missed or misinterpreted. Early recognition of any change in the morphological appearance of a cyst/peri-cystic nodule should therefore raise suspicion for malignancy by the reporting Radiologist. Surveillance of these lesions is also critical to ensure changes or progression which would be suspicious features for early lung cancer. To be aware of the mimickers like infection, cysts induced by medications, and granulomatous infection in the right clinical...
References
1. Sarah S. Lung cancers associated with cystic air spaces: Underrecognized features of early disease. Radiographics. 2018, April, 13th; Vol 38, No.3