CTICasesPulmonary Adenocarcinoma with Micropapillary Component
Imaging findings
Baseline lung cancer screening CT shows a part-solid, part-cystic pulmonary nodule in the right lung apex measuring greater than 20 millimeters. The lesion exhibits internal air bronchograms and ground-glass components, classified as a Lung-RADS 4X nodule. Pathologic resection confirms adenocarcinoma with a prominent micropapillary component.
Key takeaways
Pulmonary adenocarcinomas with a micropapillary component are aggressive subtypes characterized by a poor prognosis, high recurrence rate, and early lymphovascular invasion. The presence of a cystic component in a ground-glass or part-solid nodule on CT should increase suspicion for adenocarcinoma (sometimes raising a Lung-RADS 4X designation), requiring careful diagnostic evaluation rather than prolonged observation.
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