Lung adenocarcinoma - multifocal

Case contributed by David Pryde
Diagnosis almost certain


Presented with ongoing cough.

Patient Data

Age: 85 years
Gender: Male

Chest radiograph


Bilateral areas of lung consolidation right > left. NAD otherwise.

CT Chest


Several areas of dense lung consolidation bilaterally. The images show no hilar or mediastinal lymphadenopathy. An incidental left renal cyst is noted.

Case Discussion

The patient presented with the above chest x-ray findings of areas of bilateral consolidation. A repeat chest x-ray (not shown) after 18 days of treatment was identical. Suspicion of other pathology necessitated further assessment with CT imaging which was done 28 days after presentation. 

Subsequent biopsy proved multifocal adenocarcinoma.

This case reinforces the necessity to follow up such cases until resolution occurs. In appropriate cases, and to ensure referrer compliance, the report might well read, "Follow-up imaging is recommended in order to exclude underlying neoplasia."

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