Multinodular lung adenocarcinoma

Case contributed by Adrià Roset Altadill
Diagnosis certain

Presentation

Smoker patient presenting with one year course of dyspnea and productive cough.

Patient Data

Age: 50 years
Gender: Male

Left lower lobe atelectasis with crowded air bronchograms, resulting in left hemithorax loss of volume. 

Diffuse and coalescent ground-glass nodules predominantly in a centrilobular distribution can be observed. 

No lymph node enlargement or pleural effusion.

Case Discussion

Ultrasound-guided biopsy of the left lower lung was performed, revealing cells in keeping with lung adenocarcinoma (positive for TTF1). 

The left lower lung involvement is likely to represent the initial focus of cancer, and the diffuse ground-glass nodules are the massive airway spread. This pattern was formerly called multicentric bronchoalveolar carcinoma and is now known as invasive adenocarcinoma, which can be histologically divided into lepidic-predominant and mucinous subtypes. 

Case courtesy of Dr. Victor Pineda. 

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