Lepidic-predominant adenocarcinoma of the lung

Case contributed by Ammar Haouimi
Diagnosis almost certain


Right chest pain with pleural effusion.

Patient Data

Age: 40 years
Gender: Female

The scout view shows a para mediastinal mass of the right upper lobe with pleural effusion.

The CT scan shows a small solid nodule of the right upper lobe of para mediastinal location straddling the apical and anterior segments with irregular spiculated margins in contact with the SVC and azygos vein with no cavitation, calcification, or fatty component within. Moderate thickening with retraction of the adjacent mediastinal pleura. Mediastinal and right internal mammary lymphadenopathy.

Right pleural effusion with nodular pleural thickening (pleural metastases).

Nodular thickening of the horizontal and right oblique fissures.

Annotated image

CT-guided biopsy showing the needle within the lung mass.

Case Discussion

CT features of solid right upper lobe nodule with mediastinal and right internal mammary lymphadenopathy and pleural metastases, biopsy-proven as lepidic-predominant adenocarcinoma (LPA) of the lung.

Lepidic-predominant adenocarcinoma (LPA) of the lung, formerly known as non-mucinous bronchoalveolar carcinoma, is a subtype of invasive adenocarcinoma of the lung characterized histologically when the lepidic component comprises the majority of the lesion. 

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