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Synchronous Multifocal Pulmonary Adenocarcinomas

Imaging findings

CT chest shows three distinct, synchronous pulmonary lesions in the left lung: one solid nodule (biopsy-proven adenocarcinoma), one ground-glass nodule, and one pseudo-cavitary nodule with internal lucency.

Key takeaways

Synchronous primary lung cancers are defined as multiple distinct malignant lesions of the same or different histology. In the adenocarcinoma spectrum, patients can present with multifocal lesions ranging from pure ground-glass (representing adenocarcinoma in situ) to solid, invasive masses, requiring staging as separate primaries rather than metastases.

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