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Adenocarcinoma
Tyler H. Ternes, MD; Santiago Martínez-Jiménez, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Most common subtype of lung cancer
              • Lepidic: Neoplastic cell growth along alveolar walls
              • Term bronchioloalveolar carcinoma (BAC) no longer used

            IMAGING

            • Radiographic Findings

              • CT Findings

                • CT/Pathologic Correlation

                  • CT/Prognostic Correlation

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. American College of Radiology: Lung CT screening reporting & data system (lung-RADS). Reviewed June 28, 2021. Accessed June 28, 2021. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads
                                      2. Mendoza DP et al: Clinicopathologic and longitudinal imaging features of lung cancer associated with cystic airspaces: a systematic review and meta-analysis. AJR Am J Roentgenol. 216(2):18-329, 2021
                                      3. Halpenny D et al: Imaging of novel oncologic treatments in lung cancer part 1: systemic therapies. J Thorac Imaging. 35(1):26-36, 2020
                                      4. Shao X et al: Role of PET/CT in management of early lung adenocarcinoma. AJR Am J Roentgenol. 214(2):437-45, 2020
                                      5. Chen L et al: A radiologist's guide to the changing treatment paradigm of advanced non-small cell lung cancer: the ASCO 2018 molecular testing guidelines and targeted therapies. AJR Am J Roentgenol. 213(5):1047-58, 2019
                                      6. Kim SK et al: Lung adenocarcinoma: CT features associated with spread through air spaces. Radiology. 180431, 2018
                                      7. MacMahon H et al: Guidelines for management of incidental pulmonary nodules detected on ct images: from the Fleischner Society 2017. Radiology. 161659, 2017
                                      8. Cohen JG et al: Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients. Eur J Radiol. 84(4):738-44, 2015
                                      9. Kakinuma R et al: Solitary pure ground-glass nodules 5 mm or smaller: frequency of growth. Radiology. 141071, 2015
                                      10. Lee SM et al: CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients. Eur Radiol. 25(8):2318-25, 2015
                                      11. Mimae T et al: What are the radiologic findings predictive of indolent lung adenocarcinoma? Jpn J Clin Oncol. 45(4):367-72, 2015
                                      12. Nakamura H et al: Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer. 87(1):28-33, 2015
                                      13. Tailor TD et al: The pseudocavitation sign of lung adenocarcinoma: a distinguishing feature and imaging biomarker of lepidic growth. J Thorac Imaging. 30(5):308-13, 2015
                                      14. Sawabata N et al: Clinical predictor of pre- or minimally invasive pulmonary adenocarcinoma: possibility of sub-classification of clinical T1a. Eur J Cardiothorac Surg. 45(2):256-61, 2014
                                      15. Weichert W et al: Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med. 20(4):309-16, 2014
                                      16. Austin JH et al: Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 266(1):62-71, 2013
                                      17. Ikehara M et al: Comparison of thin-section CT and pathological findings in small solid-density type pulmonary adenocarcinoma: prognostic factors from CT findings. Eur J Radiol. 81(1):189-94, 2012
                                      18. Tsutani Y et al: Prognostic significance of using solid versus whole tumor size on high-resolution computed tomography for predicting pathologic malignant grade of tumors in clinical stage IA lung adenocarcinoma: a multicenter study. J Thorac Cardiovasc Surg. 143(3):607-12, 2012
                                      19. Travis WD et al: International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 6(2):244-85, 2011
                                      20. Onn A et al: Tumor cavitation in stage I non-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome. Radiology. 237(1):342-7, 2005
                                      21. Rossi G et al: Primary mucinous (so-called colloid) carcinomas of the lung: a clinicopathologic and immunohistochemical study with special reference to CDX-2 homeobox gene and MUC2 expression. Am J Surg Pathol. 28(4):442-52, 2004
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Most common subtype of lung cancer
                                                  • Lepidic: Neoplastic cell growth along alveolar walls
                                                  • Term bronchioloalveolar carcinoma (BAC) no longer used

                                                IMAGING

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • CT/Pathologic Correlation

                                                      • CT/Prognostic Correlation

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. American College of Radiology: Lung CT screening reporting & data system (lung-RADS). Reviewed June 28, 2021. Accessed June 28, 2021. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads
                                                                          2. Mendoza DP et al: Clinicopathologic and longitudinal imaging features of lung cancer associated with cystic airspaces: a systematic review and meta-analysis. AJR Am J Roentgenol. 216(2):18-329, 2021
                                                                          3. Halpenny D et al: Imaging of novel oncologic treatments in lung cancer part 1: systemic therapies. J Thorac Imaging. 35(1):26-36, 2020
                                                                          4. Shao X et al: Role of PET/CT in management of early lung adenocarcinoma. AJR Am J Roentgenol. 214(2):437-45, 2020
                                                                          5. Chen L et al: A radiologist's guide to the changing treatment paradigm of advanced non-small cell lung cancer: the ASCO 2018 molecular testing guidelines and targeted therapies. AJR Am J Roentgenol. 213(5):1047-58, 2019
                                                                          6. Kim SK et al: Lung adenocarcinoma: CT features associated with spread through air spaces. Radiology. 180431, 2018
                                                                          7. MacMahon H et al: Guidelines for management of incidental pulmonary nodules detected on ct images: from the Fleischner Society 2017. Radiology. 161659, 2017
                                                                          8. Cohen JG et al: Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients. Eur J Radiol. 84(4):738-44, 2015
                                                                          9. Kakinuma R et al: Solitary pure ground-glass nodules 5 mm or smaller: frequency of growth. Radiology. 141071, 2015
                                                                          10. Lee SM et al: CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients. Eur Radiol. 25(8):2318-25, 2015
                                                                          11. Mimae T et al: What are the radiologic findings predictive of indolent lung adenocarcinoma? Jpn J Clin Oncol. 45(4):367-72, 2015
                                                                          12. Nakamura H et al: Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer. 87(1):28-33, 2015
                                                                          13. Tailor TD et al: The pseudocavitation sign of lung adenocarcinoma: a distinguishing feature and imaging biomarker of lepidic growth. J Thorac Imaging. 30(5):308-13, 2015
                                                                          14. Sawabata N et al: Clinical predictor of pre- or minimally invasive pulmonary adenocarcinoma: possibility of sub-classification of clinical T1a. Eur J Cardiothorac Surg. 45(2):256-61, 2014
                                                                          15. Weichert W et al: Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med. 20(4):309-16, 2014
                                                                          16. Austin JH et al: Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 266(1):62-71, 2013
                                                                          17. Ikehara M et al: Comparison of thin-section CT and pathological findings in small solid-density type pulmonary adenocarcinoma: prognostic factors from CT findings. Eur J Radiol. 81(1):189-94, 2012
                                                                          18. Tsutani Y et al: Prognostic significance of using solid versus whole tumor size on high-resolution computed tomography for predicting pathologic malignant grade of tumors in clinical stage IA lung adenocarcinoma: a multicenter study. J Thorac Cardiovasc Surg. 143(3):607-12, 2012
                                                                          19. Travis WD et al: International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 6(2):244-85, 2011
                                                                          20. Onn A et al: Tumor cavitation in stage I non-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome. Radiology. 237(1):342-7, 2005
                                                                          21. Rossi G et al: Primary mucinous (so-called colloid) carcinomas of the lung: a clinicopathologic and immunohistochemical study with special reference to CDX-2 homeobox gene and MUC2 expression. Am J Surg Pathol. 28(4):442-52, 2004