Adenocarcinoma of the lung

Adenocarcinoma of the lung is one of the non-small cell carcinomas of the lung and is a malignant tumour with glandular differentiation or mucin production. This tumour exhibits various patterns and degrees of differentiation, including lepidic, acinar, papillary, micropapillary and solid with mucin formation 1

It is now considered the most common histological subtype in terms of prevalence.

Early symptoms are fatigue with mild dyspnoea followed by chronic cough and haemoptysis at a later stage.

Classification of the tumour subtype is based on the estimate of the percentage of histologic patterns and the predominant subtype. The terminology of mixed subtype is to be avoided:

Variants of invasive adenocarcinoma

Sometimes it is impossible to radiographically distinguish between other histological lung cancer types.

A lung nodule is a rounded or irregular region of increased attenuation measuring less than 3 cm. The amount of attenuation can further classify the nodules as either ground glass, sub-solid or solid.1,2 

Histologically, the ground-glass attenuation corresponds to a lepidic growth pattern and the solid component correspond to invasive patterns. Hence the preinvasive category of AIS, MIA, and the invasive subtype of LPA is often seen as ground glass nodule or sub-solid nodule with a predominant ground-glass component. On the other hand, the remaining invasive subtypes of adenocarcinoma  is usually a solid nodule but may also subsolid  and only occasionally seen as ground glass nodule 1,2

Invasive mucinous adenocarcinoma subtype (formerly mucinous BAC) can have a variable appearance ranging from consolidation, air bronchograms or seen as multifocal subsolid nodules or masses 2

Recommendation for follow-up of solid nodules is as per Fleischner Society guidelines. Recommendation for ground glass or subsolid nodules has recently been proposed, please consult Naidich et article - Recommendations for the management of sub-solid pulmonary nodules detected at CT: a statement from the Fleischner Society 3.


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Article Information

rID: 22314
System: Chest
Section: Pathology
Tag: rewrite
Synonyms or Alternate Spellings:
  • Pulmonary adenocarcinoma
  • Adenocarcinoma of lung
  • Invasive adenocarcinoma of lung
  • Adenocarcinoma of the lungs
  • Adenocarcinoma of lungs
  • Invasive adenocarcinoma of the lung
  • Invasive adenocarcinoma of the lungs
  • Invasive adenocarcinoma of lungs

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Cases and Figures

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    Case 3: with chest wall invasion
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    Case 5: lepidic predominant
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    Case 6: right upper lobe
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