CT and clinicopathological features of thin-walled cystic lung cancer with the largest diameter less than or equal to 3 cm_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Zhan ¹ , ZHANG Zhenrong ¹ , SUN Hongliang ² ,  LIU Deruo ¹

1. Department of Thoracic Surgery, China-Japan Friendship Hospital, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, P. R. China;
2. Department of Radiology, China-Japan Friendship Hospital, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, P. R. China;

Corresponding author：

LIU Deruo, Email: deruoliu@vip.sina.com

Keywords：

Lung cancer; thin-walled cyst; computed tomography; pathology

DOI：

10.7507/1007-4848.201905015

Video：

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Objective To investigate the CT features and clinicopathological features of thin-walled cystic lung cancer with the largest diameter less than or equal to 3 cm.Methods The CT features and clinicopathological data of 26 thin-walled cystic lung cancer patients diagnosed by chest CT and surgical or puncture pathology were retrospectively analyzed. There were 16 males and 10 females, with an average age of 62 years.Results The lesions were distributed in different pulmonary lobes, all of which were peripheral. The maximum diameter of lesion was 21.4 mm on average, and the maximum diameter of cyst was 12.9 mm on average. Among them, there were 19 patients of lobulation sign, 18 patients of spicule sign, 16 patients of pleural indentation, 9 patients of vascular convergence sign, 7 patients of bronchus sign, 21 patients of irregular inner wall, 26 patients of uneven thickening of cystic wall, 18 patients of intra-cystic separation, and 10 patients of vessels through the cystic cavity. The pathological types were all adenocarcinoma and 24 patients were invasive adenocarcinoma.Conclusion All patients were peripheral adenocarcinoma. CT not only shows the common typical signs of lung cancer, but also has the characteristic fertures of irregular inner wall, intra-cystic separation and vessels through the cystic cavity.

Citation： LIU Zhan, ZHANG Zhenrong, SUN Hongliang, LIU Deruo. CT and clinicopathological features of thin-walled cystic lung cancer with the largest diameter less than or equal to 3 cm. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1074-1078. doi: 10.7507/1007-4848.201905015 Copy

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7.	Xue X, Wang P, Xue Q, et al. Comparative study of solitary thin-walled cavity lung cancer with computed tomography and pathological findings. Lung Cancer, 2012, 78(1): 45-50.
8.	Nakahara Y, Mochiduki Y, Miyamoto Y. Percutaneous needle washing for the diagnosis of pulmonary thin-walled cavitary lesions filled with air. Intern Med, 2007, 46(14): 1089-1094.
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12.	Travis WD, Brambilla E, Noguchi M, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285.
13.	Qi Y, Zhang Q, Huang Y, et al. Manifestations and pathological features of solitary thin-walled cavity lung cancer observed by CT and PET/CT imaging. Oncol Lett, 2014, 8(1): 285-290.
14.	Guo J, Liang C, Sun Y, et al. Lung cancer presenting as thin-walled cysts: An analysis of 15 cases and review of literature. Asia Pac J Clin Oncol, 2016, 12(1): e105-112.
15.	Woodring JH, Fried AM, Chuang VP. Solitary cavities of the lung: diagnostic implications of cavity wall thickness. AJR Am J Roentgenol, 1980, 135(6): 1269-1271.
16.	望云, 刘士远, 范丽, 等. 含薄壁囊腔周围型肺癌的CT特征及病理基础分析. 中华放射学杂志, 2017, 51(2): 96-101.
17.	Fintelmann FJ, Brinkmann JK, Jeck WR, et al. Lung cancers associated with cystic airspaces: natural history, pathologic correlation, and mutational analysis. J Thorac Imaging, 2017, 32(3): 176-188.
18.	Womack NA, Graham EA. Epithelial metaplasia in congenital cystic disease of the lung: Its possible relation to carcinoma of the bronchus. Am J Pathol, 1941, 17(5): 645-654.
19.	de Torres JP, Bastarrika G, Wisnivesky JP, et al. Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest. Chest, 2007, 132(6): 1932-1938.
20.	Goto T, Maeshima A, Oyamada Y, et al. Cavitary lung cancer lined with normal bronchial epithelium and cancer cells. J Cancer, 2011, 2: 503-506.
21.	Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol, 2015, 10(9): 1243-1260.
22.	Ambrosini V, Nicolini S, Caroli P, et al. PET/CT imaging in different types of lung cancer: an overview. Eur J Radiol, 2012, 81(5): 988-1001.
23.	Onn A, Choe DH, Herbst RS, et al. Tumor cavitation in stageⅠnon-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome. Radiology, 2005, 237(1): 342-347.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Chen W, Zheng R, Peter DB, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Farooqi AO, Cham M, Zhang L, et al. Lung cancer associated with cystic airspaces. AJR Am J Roentgenol, 2012, 199(4): 781-786.
4. Horeweg N, Scholten ET, de Jong PA, et al. Detection of lung cancer through low-dose CT screening (NELSON): a prespecified analysis of screening test performance and interval cancers. Lancet Oncology, 2014, 15(12): 1342-1350.
5. Scholten ET, Horeweg N, de Koning HJ, et al. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening. Eur Radiol, 2015, 25(1): 81-88.
6. Watanabe Y, Kusumoto M, Yoshida A, et al. Cavity wall thickness in solitary cavitary lung adenocarcinomas is a prognostic indicator. Ann Thorac Surg, 2016, 102(6): 1863-1871.
7. Xue X, Wang P, Xue Q, et al. Comparative study of solitary thin-walled cavity lung cancer with computed tomography and pathological findings. Lung Cancer, 2012, 78(1): 45-50.
8. Nakahara Y, Mochiduki Y, Miyamoto Y. Percutaneous needle washing for the diagnosis of pulmonary thin-walled cavitary lesions filled with air. Intern Med, 2007, 46(14): 1089-1094.
9. Xue XY, Liu YX, Wang KF, et al. Computed tomography for the diagnosis of solitary thin-walled cavity lung cancer. Clin Respir J, 2015, 9(4): 392-398.
10. Mascalchi M, Attina D, Bertelli E, Bertelli E, et al. Lung cancer associated with cystic airspaces. J Comput Asist Tomogr, 2015, 39(1): 102-108.
11. Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
12. Travis WD, Brambilla E, Noguchi M, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. J Thorac Oncol, 2011, 6(2): 244-285.
13. Qi Y, Zhang Q, Huang Y, et al. Manifestations and pathological features of solitary thin-walled cavity lung cancer observed by CT and PET/CT imaging. Oncol Lett, 2014, 8(1): 285-290.
14. Guo J, Liang C, Sun Y, et al. Lung cancer presenting as thin-walled cysts: An analysis of 15 cases and review of literature. Asia Pac J Clin Oncol, 2016, 12(1): e105-112.
15. Woodring JH, Fried AM, Chuang VP. Solitary cavities of the lung: diagnostic implications of cavity wall thickness. AJR Am J Roentgenol, 1980, 135(6): 1269-1271.
16. 望云, 刘士远, 范丽, 等. 含薄壁囊腔周围型肺癌的CT特征及病理基础分析. 中华放射学杂志, 2017, 51(2): 96-101.
17. Fintelmann FJ, Brinkmann JK, Jeck WR, et al. Lung cancers associated with cystic airspaces: natural history, pathologic correlation, and mutational analysis. J Thorac Imaging, 2017, 32(3): 176-188.
18. Womack NA, Graham EA. Epithelial metaplasia in congenital cystic disease of the lung: Its possible relation to carcinoma of the bronchus. Am J Pathol, 1941, 17(5): 645-654.
19. de Torres JP, Bastarrika G, Wisnivesky JP, et al. Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest. Chest, 2007, 132(6): 1932-1938.
20. Goto T, Maeshima A, Oyamada Y, et al. Cavitary lung cancer lined with normal bronchial epithelium and cancer cells. J Cancer, 2011, 2: 503-506.
21. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol, 2015, 10(9): 1243-1260.
22. Ambrosini V, Nicolini S, Caroli P, et al. PET/CT imaging in different types of lung cancer: an overview. Eur J Radiol, 2012, 81(5): 988-1001.
23. Onn A, Choe DH, Herbst RS, et al. Tumor cavitation in stageⅠnon-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome. Radiology, 2005, 237(1): 342-347.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

CT and clinicopathological features of thin-walled cystic lung cancer with the largest diameter less than or equal to 3 cm

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