CTICasesDiffuse Bilateral Mucinous Adenocarcinoma (Acinar/Lobular/Consolidative Pattern)
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Imaging findings
A radiograph showed extensive lung consolidation. Thin-cut CT images revealed a spectrum of opacities, starting with small centrilobular opacities (likely a portion of one acinus), progressing to increased opacification within pulmonary lobules, and eventually becoming confluent. The disease advanced to diffuse globular, segmental, and lobar consolidation, with small patent airways visible within the opacified lobules (air bronchograms). Some 'Cheerio' signs and 'tree-in-bud' patterns were also noted.
Key takeaways
This is a dramatic and instructive teaching case demonstrating the progression of diffuse bilateral mucinous adenocarcinoma (with bronchorrhea) from an acinar/centrilobular pattern to lobular opacification and ultimately confluent consolidation. It illustrates the classic pattern recognition for this type of adenocarcinoma.
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