CTICasesInfiltrating Adenocarcinoma of the Lung with Tracheobronchial and Esophageal Invasion
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Imaging findings
Chest CT shows severe, dense, circumferential wall thickening of the distal trachea, the carina, the right main bronchus, and the origin of the left main bronchus, causing significant luminal narrowing. There is also associated diffuse esophageal wall thickening and paratracheal lymphadenopathy without a discrete, mass-like parenchymal lung lesion. Bronchoscopy reveals irregular, congested, and edematous mucosal thickening at the carina.
Key takeaways
Primary bronchogenic carcinoma, particularly poorly differentiated adenocarcinoma, can occasionally present as a diffuse, infiltrating process along the central airways and esophagus rather than a discrete parenchymal mass. This infiltrative growth pattern can mimic benign inflammatory/infectious tracheobronchial diseases or esophageal pathology and typically represents advanced (T4) non-resectable disease.
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