CTICasesSynchronous Primary Lung Adenocarcinomas
Imaging findings
CT chest shows a solid, speculated nodule in the right upper lobe (biopsy-proven adenocarcinoma) and a separate, round ground-glass nodule in the right lower lobe, representing synchronous primary adenocarcinomas without direct pleural or vascular communication.
Key takeaways
Identifying multiple pulmonary nodules in a patient with lung cancer raises the question of intrapulmonary metastasis versus separate primary tumors. A ground-glass or part-solid appearance in the second nodule strongly favors a synchronous primary adenocarcinoma (often adenocarcinoma in situ or minimally invasive adenocarcinoma), which carries a better prognosis than metastatic disease.
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