Lepidic adenocarcinoma is an invasive non-mucinous adenocarcinoma of lung that shows predominantly lepidic growth pattern. It consists of atypical type II pneumocytes or Clara cells growing along the surface of alveolar septa The Invasive Mucinous Adenocarcinoma of Lung can have any histological pattern; the most common pattern noted is lepidic. Other patterns that may be present include the papillary, micropapillary, or acinar; however, the solid pattern is generally not note 36 year old woman at 33 weeks gestation presenting with orthopnea caused by lepidic predominant lung adenocarcinoma (Case Rep Oncol 2018;11:822) 59 year old woman presenting with mucinous adenocarcinoma mimicking pulmonary fibrosis (BMC Cancer 2016;16:729) 60 year old man with fast growing lung micropapillary predominant adenocarcinoma (Respir Med Case Rep 2017;20:125 In 2011, the pathological classification of lung adenocarcinoma was jointly revised by the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society . The former terminology adenocarcinoma with bronchiololalveolar features was recategorised as nonmucinous lepidic predominant adenocarcinoma (NM L-ADC) or mucinous variant (M L-ADC)
Abstract: Although the clinical entity of bronchioloalveolar carcinoma (BAC) has been reclassified into adenocarcinoma in situ, lepidic predominant adenocarcinoma, and mucinous adenocarcinoma, it continues to merit special consideration based on its distinct natural history and response to therapy . Subtypes: nonmucinous, mucinous, mixed mucinous/nonmucinous. Definition: lack of invasion into the stroma, vascular spaces and pleura. Must have a lepidic growth pattern If exclusively lepidic on biopsy report as Adenocarcinoma, lepidic pattern (or something similar). On resection, this could represent Adenocarcinoma in situ (AIS), Minimally invasive adenocarcinoma, or simply a lepidic component of an invasive adenocarcinoma. Radiographic correlation is required pre-operatively
. 1 Increasing numbers of non-smokers and never-smokers are developing lung adenocarcinoma. 2. The classification of lung adenocarcinoma was revised in 2011 at which time the term bronchoalveolar carcinoma was removed. Four new terms were introduced to. In the new classification, BAC may be referred to as lepidic predominant adenocarcinoma based on the typical growth pattern of the tumor. Bronchioloalveolar carcinomas may appear as a single spot in the periphery of the lungs, or as scattered spots throughout one or both lungs
Lung parenchyma away from the tumor is unremarkable. There is some mild subpleural fibrosis and emphysema in one of the sections. Two lymph nodes show no evidence of metastatic carcinoma. DIAGNOSIS: Left upper lobectomy: * Lepidic predominant adenocarcinoma. - Lepidic component 60%, acinar component 40%. - Size - 22mm. - No pleural invasion Carcinoma is a type of cancer that starts in the cells that line organs. In the lung, carcinomas can start in the cells that line the inside of the bronchi, bronchioles, and alveoli. Carcinoma is the most common kind of lung cancer. In fact, when someone says they have lung cancer, they usually mean that they have a carcinoma Malignant epithelial tumor with glandular differentiation, mucin production, or pneumocyte marker expression. Lung Cancer (including other carcinoma types) is the most common cause of cancer death world-wide Lung Cancer Facts Due to the enormous variance of history and therapeutic response, a correct histological diagnosis is necessary. Over the past 25 years adenocarcinoma has become the histological subtype most frequently associated with both sexes and all races combined, replacing squamous cell The most common form of lung cance
The 2015 World Health Organization (WHO) lung adenocarcinoma classification divides tumours into categories of indolent pre-invasive, minimally invasive and predominantly lepidic and, by examining predominant patterns of invasion, allows for further stratification into intermediate and high-grade tumours It tends to arise in the distal bronchioles or alveoli and is defined by a non-invasive growth pattern. This small solitary tumor exhibits pure alveolar distribution (lepidic growth) and lacks any invasion of the surrounding normal lung. If completely removed by surgery, the prognosis is excellent with up to 100% 5-year survival
. 2021 Aug 6. doi: 10.1111/his.14537. Online ahead of print.ABSTRACTElastin and collagen are the main components of the lung connective tissue network and together provide the lung with elasticity and tensile strength. In pulmonary pathology elastin stain is used to a variable extent in different countries Invasive mucinous adenocarcinoma and colloid carcinoma are described as variants of invasive adenocarcinoma. Adenocarcinoma in situ (AIS), formerly known as bronchioloalveolar carcinoma (BAC) is a localized small (less than 3.0 cm) lesion with tumor growth restricted to preexisting alveolar spaces (lepidic growth), lacking stromal, vascular, or.
Background: Stage I lung adenocarcinoma with a lepidic component has a good prognosis after sublobar resection. The purpose of this study is to evaluate the prognosis of wide wedge resection in patients diagnosed with stage IA1 and IA2 lung adenocarcinoma (based on the eighth edition of the TNM staging system) in which the total tumor size, including the lepidic component, is more than 2 cm Publication of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification of lung adenocarcinomas in 2011 aimed to provide better stratification of these lesions by establishing that not all lesions with lepidic features have the same biology. 3 This.
tion and solid mass in the lungs corresponded to lepidic pre-dominant adenocarcinoma and sarcomatoid carcinoma con-taining OGCs, respectively. This tumor incidence is very unique, and this is the first case to present sarcomatoid car-cinoma containing OGCs combined with diffused invasive lepidic predominant adenocarcinoma in the lung. We per The literature is inconclusive as to whether the percentage of the lepidic component of an invasive adenocarcinoma (AC) of the lung influences prognosis. We studied a population-based series of selected, resected invasive pulmonary ACs to determine if incremental increases in the lepidic component were an independent, prognostic variable ncer (NSCLC) involving the left main bronchus. The patient received induction chemotherapy and then underwent a left pneumonectomy. Histopathology revealed a moderately differentiated adenocarcinoma of the lung, but instead of consolidation, there was diffuse tumor spread along intact alveolar walls (lepidic) throughout the left upper lobe in the resected specimen. FDG-PET and CT studies that. Lepidic Adenocarcinoma Lepidic growth is commonly seen in lung adenocarcinoma. The lepidic growth pattern denotes tumor cells spreading along preexisting alveolar structures, although there may be sclerotic thickening of alveolar septa. When it is the predominant growth pattern with additional findings that set it apart from previously.
changes in the WHO classification of lung adenocarcinoma and small biopsies of lung cancer. Dr. Roden, thank you for presenting with us today. Thank you very much for the nice introduction. There is a predominant lepidic growth pattern; and in contrast to adenocarcinoma in situ, we do find focal stromal invasion, which should not exceed 0.5. Lepidic pattern is defined as a tumor composed of neoplastic cells lining the alveolar lining with no architectural disruption/complexity, and no lymphovascular and/or pleural invasion. Most lung adenocarcinomas demonstrate a mixture of different histologic patterns It is important to distinguish bronchiolar adenoma from lepidic adenocarcinoma or adenocarcinoma in situ based on the morphology of the two-layer epithelial cell perforation, he said. Thoracic SMARCA4-Deficient Undifferentiated Tumor is a highly malignant, undifferentiated lung tumor with or without pleural chest wall invasions Thus, we have implemented the 20% cutoff in the model and proposed a new grading system—the IASLC grading system—for pulmonary adenocarcinoma, as summarized in the Table. In accordance with the system, a tumor that is composed predominantly of acinar pattern (60%) with 30% lepidic and 10% micropapillary patterns is graded as moderately.
Adenocarcinoma of the lung is a type of non-small cell lung cancer. It occurs when abnormal lung cells multiply out of control and form a tumor. Eventually, tumor cells can spread (metastasize) to other parts of the body including the. lymph nodes around and between the lungs. liver imally invasive adenocarcinoma (MIA) as well as lepidic predominant adenocarcinoma (LPA). Recent findings The concept of a continuum between the precursor lesions AAH and AIS to MIA and frankly invasive ADC is backed by a wealth of recent data showing a gradual decrease in overall survival from 100% for AAH, AIS, and MIA to moderately lower rates for LPA. Further, it has been shown that the.
with pure lepidic growth termed adenocarcinoma in situ. • Small ( ≤3 cm) solitary adenocarcinomas with predominant lepidic growth and foci of invasion measuring ≤ 0.5 cm termed minimally invasive adenocarcinoma. Lepidic Growth • Maintains alveolar architecture - No destruction or effacement • No central or broad sca Lung adenocarcinoma is characterized by marked heterogeneity and may be composed of an admixture of histologic growth patterns, including acinar, papillary, solid, and lepidic (bronchioloalveolar) Lepidic samples were enriched for lung alveolar and epithelial markers, supporting a similar cell identity between lepidic cancer cells and normal lung tissue, whereas both lymphoid and myeloid immune cell types were invariably enriched in acinar- and solid-prevalent samples, in both the TCGA and EAS (Supplementary Fig. S1J) cohorts. Overall. lepidic: ( lĕ-pid'ik ), Relating to scales or a scaly covering layer. [G. lepis ( lepid- ), scale, rind
In the literature, EGFR mutations have largely been associated with bronchioloalveolar adenocarcinoma, invasive adenocarcinomas with prominent lepidic growth, and papillary adenocarcinoma. 7, 11, 20, 23, 24 Micropapillary adenocarcinoma of the lung needs to be added to this group, although as emphasized before, mutations in this group are not. Lung adenocarcinoma is currently staged based on invasive tumor size, excluding areas of lepidic (in situ) growth. Invasive tumor size may be determined by pathologic assessment of a surgical specimen or radiographic assessment on computerized tomography (CT) scan. When invasive tumor size is the pr .1.2.2 Adenocarcinoma In Situ (AIS) (Fig..2) AIS is a newly introduced entity in the current WHO classification [ ]. It is a small (<=3 cm), localized adenocarcinoma with neoplastic cell growth restricted along alveolar walls (pure lepidic growth), lacking stromal, vascular, or pleural invasion Lepidic predominant adenocarcinoma is deﬁned as a tumor with 45-mm invasion or 43 cm in total size. Then, the predominant histologic pattern is deter- Read Content. Lung cancer, also known as lung carcinoma,  is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung
Lung adenocarcinoma is a cancer that occurs due to abnormal and uncontrolled cell growth in the lungs. It is a subtype of non-small cell lung cancer that is often diagnosed in an outer area of the lung. Early lung cancers may not be associated with any signs and symptoms. As the condition progresses, affected people can experience chest pain, a persistent cough, fatigue, coughing up blood. The lung is composed of two different tissue units, the terminal respiratory unit (TRU) and the central airway compartment (CAC). In the nonsmokers' pathway, LADCs develop from the TRU, and their histological appearances change from lepidic to micropapillary during the progression process The current paradigm is that untreated lung cancer is invariably and rapidly fatal, therefore the medical community normally dismisses the idea that a patient could live with such a disease for years without any therapy. Yet evidence from lung cancer screening research and from recent clinical series suggests that, although rarely recognised in routine practice, slow-growing lung cancers do. INTRODUCTION. Adenocarcinoma (ADC) is the most common histologic subtype of lung cancer that encompasses a heterogeneous group of malignancies with different morphologic features, etiology, and molecular changes. 1 The most recent World Health Organization (WHO) classification of lung carcinoma includes a list of various morphologic variants of lung ADC but does not take into consideration. Figure 2 Biopsy nomenclature for lepidic growth pattern (BAC features or BAC pattern). (a) A semisolid nodule, a biopsy of which was obtained. The longer arrow passes through the ground-glass periphery of the nodule, resulting in the purely alveolar growth/lepidic pattern tumor sample in panel b. If the trajectory of the biopsy followed, the arrowhead through the mass a different potentially.
DISCUSSION: Multifocal ground glass lepidic (GG/L) lung adenocarcinoma is generally thought to represent separate primary tumors in varying stages of progression, making staging and treatment challenging. However, through exome sequencing, Li et al. has recently hypothesized that they are the result of intrapulmonary metastasis. Survival rates are dependent on the nodule location with multiple. Noninvasive lepidic adenocarcinoma (left) juxtaposed with adjacent uninvolved lung parenchyma (right). The lepidic adenocarcinoma is characterized by thickened alveolar septa lined by atypical overlapping cuboidal cells. Contributed by Jonathan Keow, M.D., Ph.D Lung, right lower lobe, wedge excision (A): Invasive moderately differentiated adenocarcinoma with focal lepidic pattern (pT1a, pN0). Right lower lobe, completion lobectomy (F): Separate focus of well differentiated adenocarcinoma with lepidic pattern (<4mm) (see comment)
Lung cancer is the most frequent human malignancy and the principal cause of cancer-related death worldwide. Adenocarcinoma is now the main histologic type, accounting for almost half of all the cases. The 2015 World Health Organization has adopted the classification recently developed by the International Association for the Study of Lung Cancer, American Thoracic Society, and European. CONCLUSION: In small-sized lung adenocarcinoma, lepidic-predominant histological subtype is the best prognostic factor, and a low incidence of lymphatic vessel invasion in the histological subtype is a key factor for an excellent prognosis - Adenocarcinoma in situ: AIS (<3 cm formerly BAC) • Nonmucinous, and/or Mucinous • Minimally invasive adenocarcinoma: MIA (<3 cm lepidic predominant tumor with <5 mm invasion) • Invasive adenocarcinoma -Lepidic predominant (formerly nonmucinous BAC pattern, with >5 mm invasion) -Acinar predominant, -papillary predominant Lung adenocarcinoma is the most typical histologic subtype of lung cancer tumors generally in most nations (8). In the decade that is past numerous improvements have taken spot in oncology, molecular biology, pathologic examination, radiology, and surgery of lung adenocarcinoma. and lepidic predominant adenocarcinoma that is invasive. (e. Acinar-papillary adenocarcinoma had a higher SUVmax than lepidic adenocarcinoma, with SUVmax 1.4 the optimal cutoff value for differentiation. In stage IA lung adenocarcinoma characterized by.
Now the leading subtype of lung cancer, adenocarcinoma received a new classification in 2011. For tumors catego-rized previously as bronchioloalveolar carcinoma (BAC), solid; and lepidic invasive mu-cinous adenocarcinoma is invasive mucinous adenocarcinoma show ing predominantly lepidic growth and, at CT, variable patterns, an lung transplant in March of 2007 with lung from a 19-year-old donor. The explanted lungs exhibited diffuse consolidation throughout all lobes with high-grade adenocarcinoma with lepidic spread, but no deﬁnite stromal invasion. The carcinoma was negative by ﬂuo-rescence in situ hybridization forMET ampliﬁcation o Lung cancer: Non-small cell lung cancer accounts for 80 percent of lung cancers, and adenocarcinoma is the most common type. Prostate cancer: Cancer that forms in the prostate gland is typically an adenocarcinoma, which accounts for 99 percent of all prostate cancers. Read about the symptoms of prostate cancer
Mucinous adenocarcinoma is often considered a relatively poor prognostic group among adenocarcinomas of the lung and has a high rate of pulmonary recurrence. Pathologic parameters predicting poor outcome have not been extensively studied, including the presence of spread through alveolar spaces (STAS). We retrospectively studied time to lung recurrence and time to distant metastasis in 30. Adenocarcinoma is the most common type of lung cancer found in non-smokers and is usually seen as a peripheral lesion in the lungs, as compared to centrally located tumors such as small cell lung cancer and squamous cell lung cancer. 6q23-25 locus has been identified as a susceptibility gene for familial lung cancer /3 codes were available for mucinous adenocarcinoma of the lung. It has been recognized tha. t . not all lung cancers are invasive /3 so new codes were implemented. B. Non-mucinous carcinoma/adenocarcinoma • 8256/3 . when ο Microinvasive ο Minimally invasive • 8250/2. when ο Preinvasive ο In situ . Lung Solid Tumor Rules December 2020. Invasive lung adenocarcinomas that have a predominant lepidic component are termed lepidic adenocarcinomas, though these can be even further sub-characterized as adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA), depending on size and degree of lepidic growth pattern (see Fig. 1)
Adenocarcinoma of the lung is the most common type of lung cancer, and like other forms of lung cancer, it is characterized by distinct cellular and molecular features. It is classified as one of several non-small cell lung cancers (NSCLC), to distinguish it from small cell lung cancer which has a different behavior and prognosis. Lung adenocarcinoma is further classified into several subtypes. Now the leading subtype of lung cancer, adenocarcinoma received a new classification in 2011. For tumors categorized previously as bronchioloalveolar carcinoma (BAC), criteria and terminology had not been uniform, so the 2011 classification provided four new terms: (a) adenocarcinoma in situ (AIS), representing histopathologically a small (≤3-cm), noninvasive lepidic growth, which at. The major changes in the 2015 WHO classification of adenocarcinomas of the lung (resected tumors) are: 1) Discontinuing the terms bronchioloalveolar carcinoma and mixed subtype adenocarcinoma; 2) Adding Adenocarcinoma-in-situ to the list of pre-invasive lesions; 3) Introducing the concept of minimally-invasive adenocarcinoma; 4) Classification.
Lung cancer is the second most common cancer in American men and women. It's also the leading cause of cancer-related deaths for both American men and women.. According to the American Lung. Prognostic significance of adenocarcinoma in situ, minimally invasive adenocarcinoma, and nonmucinous lepidic predominant invasive adenocarcinoma of the lung in patients with stage I disease. Am J. However, an exception to this general rule is adenocarcinoma in situ (aka minimally invasive adenocarcinoma or adenocarcinoma of the lepidic spectrum, Tyrosine kinase inhibitors like erlotinib, now frequently used in advanced adenocarcinoma of the lung, may be associated with interstitial lung disease and acute lung injury. Everolimus, whic
An unusual case of a microscopic alveolar adenoma coexisting with lung carcinoma: a case report and review of the literature. J Med Case Rep 2011;5:187. 6. Kawatsu Y, Kitada S, Uramoto H, et al. The combination of strong expression of ZNF143 and high MIB-1 labelling index independently predicts shorter diseasespecific survival in lung. Lung Cancer TNM Staging. 1. Primary Tumour (T) Tumour ≤1 cm in greatest dimension. A superficial, spreading tumour of any size whose invasive component is limited to the bronchial wall and may extend proximal to the main bronchus also is classified as T1a, but these tumours are uncommon The lepidic pattern is predominant but there might be other growth patterns. 5 mm stromal invasion. minimally invasive adenocarcinoma. Lepidic growth pattern. Lack of stromal, vascular or pleural invasion. lung cancer that have early invasion to visceral pleura, chest and adjacent structures. large cell carcinoma. large cell carcinoma. Carcinoma Includes non-small cell carcinoma, small cell carcinoma, and carcinoid tumor of the lung . This protocol is NOT required for accreditation purposes for the following: Procedure Biopsy Primary resection specimen with no residual cancer (e.g. following neoadjuvant therapy) Cytologic specimen
PINION Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma Wilko Weichert and Arne Warth Purpose of review This review gives a comprehensive overview on recent developments in the classification of neoplastic lung lesions with lepidic growth patterns. stage in patients with lung adenocarcinoma (LUAD). Methods: A retrospective data set including 863 cases of LUAD with lepidic component and 856 cases without lepidic component was used to identify matched lepidic-positive and lepidic-negative cohorts (n = 376 patients per group) using a propensity-score matching These lesions are associated with bronchioloalveolar carcinoma representing lepidic growth. We present a case of rapidly worsening shortness breath and cough. Multiple lung cancers may be. Ground-glass opacity (GGO) on CT images and the corresponding lepidic growth pattern observed by microscopy are considered noninvasive components. 1,2 Many studies have revealed that invasive size (tumor size excluding the GGO or lepidic component) is a better predictor of survival than total tumor size. 3 -8 Thus, the eighth edition of Lung.
For lepidic pattern tumors with a confluent focus of invasion >5 mm, and the term lepidic predominant adenocarcinoma should be used if the lepidic pattern is the clear majority Uncommon Types of Lung Carcinoma With Mixed Histology: Sarcomatoid Carcinoma, Adenosquamous Carcinoma, and Mucoepidermoid Carcinoma The presence of STAS is an exclusion point in the diagnosis of minimally invasive adenocarcinoma (MIA), a small, solitary adenocarcinoma ([less than or equal to] 3 cm) with predominantly lepidic pattern and.
Lung Cancer and Paraneoplastic Syndromes Amita Vasoya D.O. FACOI, FCCP, FAASM Christiana Care Pulmonary Associates Clinical Assistant Professor of Medicine Sidney Kimmel Medical College of Thomas Jefferson University Lepidic growth Tumor cells line alveolar walls The percentage of lepidic growth is an independent prognostic factor in invasive adenocarcinoma of the lung Trond-Eirik Strand1*, Hans Rostad1, Erik H. Strøm2 and Philip Hasleton3,4 Abstract Background: The literature is inconclusive as to whether the percentage of the lepidic component of an invasive adenocarcinoma (AC) of the lung influences. ADENOCARCINOMA Lung cancer is the most frequent cause of major cancer incidence and mortality worldwide.1,2 Adenocarcinoma is the most common histologic subtype of lung cancer in most coun-tries, accounting for almost half of all lung cancers.3 A widely divergent clinical, radiologic, molecular, and pathologic spec-trum exists within lung. With an SUV max cutoff value of 1.4 to differentiate predominantly lepidic tumors from predominantly acinar-papillary tumors in early lung adeno-carcinoma with and without solid components (OR, 3.529; p < 0.05), our results suggest that SUV max can be used as an imaging parameter to differentiate the growth pattern of invasive lung adenocarcinoma In the new pathologic classification of lung adenocarcinoma proposed by IASLC/ATS/ERS in 2011, lepidic type adenocarcinomas are constituted by three subtypes; adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and lepidic predominant invasive adenocarcinoma (LPIA). Although these subtypes are speculated to show sequential progression from preinvasive lesion to invasive lung.
Most of the lung adenocarcinoma has mixed histologic type; however, lepidic-predominant lung adenocarcinoma has the best prognosis. Solitary tumors, which are <3 cm in size, with pure lepidic pattern with no evidence of invasion are now termed as adenocarcinoma in situ and the term bronchoalveolar carcinoma is no longer used Histopathology. 2021 Aug 6. doi: 10.1111/his.14537. Online ahead of print.ABSTRACTElastin and collagen are the main components of the lung connective tissue network and together provide the lung with elasticity and tensile strength. In pulmonary pathology elastin stain is used to a variable extent in different countries Morphology -Bronchioloalveolar carcinoma• Not related to: Gender, occupation, social class, cigarette smoking• Highly diff Ca, grows upon the walls of pre- existing alveoli - lepidic spread• Histologically cells have peg like luminal aspects with no stromal reaction 28. Radiologically they mimic Pneumonia 29
Small cell lung cancer accounts for around 20% of all lung cancers. 34 Due to tumor biology, treatment and prognosis greatly differ from nonsmall cell lung cancer described above. Since it is often associated with ectopic hormone production, it frequently causes paraneoplastic syndromes, in particular Cushing syndrome or Schwartz-Bartter. Background: Due to their abundant vascular supply, the lungs are a usual metastatic site, with primary lung cancer presenting a low prevalence in dogs and cats. Among the primary pulmonary tumors afflicting dogs, lepidic carcinoma is the most common and can be classified by site of onset. Lepidic predominant adenocarcinoma is characterized by the proliferation of neoplastic cells along the. Lesions that meet the criteria for adenocarcinoma in situ have formerly been classified as BAC according to the strict definition of the 1999 2 and 2004 3 WHO classifications and as type A and B adenocarcinoma according to the 1995 Noguchi classification. 5 Multiple observational studies on solitary lung adenocarcinomas with pure lepidic growth. The eighth edition TNM stage classiﬁcation for lung cancer: What does it mean on main street? Frank C. Detterbeck, MD FeatureEditor'sNote—The eighth edition of theAmerican Joint Commission on Cancer TNM staging system for non- small cell lung cancer was introduced in January 2017 and will be implemented in the United States in January 2018 Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. There are three main types: Adenocarcinoma -This develops from mucus-producing cells that line the airways.; Squamous cell carcinoma - This develops in the cells that line the airways.; Non-small cell lung cancer not otherwise specified (NOS) - This is when the pathologist cannot say for certain which type of.
Among adenocarcinomas, the pseudocavitation sign was more frequent in tumors with lepidic growth versus those without lepidic growth [10/24 (41.7%) vs. 9/62 (14.5%), P=0.015]. CONCLUSIONS: Pseudocavitation at CT is more common in primary lung adenocarcinoma than in other types of NSCLC We have multifocal adenocarcinoma of the lung. @linda10 and @sakota.-Please join me in this discussion. For a short explanation of this tongue twister. Briefly, Multifocal Adenocarcinoma (MAC) of the lung is a clinical entity of multiple synchronous (less than 6 months) or metachronous (more than 6 months), often ground-glass opacities (GGO) on CT scan, typically indolent-behaving cancers Lung cancer is the most common and deadly cancer, accounting for about 1.76 million deaths globally. In general, adenocarcinoma is characterized by the presence of a lepidic pattern, which. Adenocarcinoma is the most frequent histological subtype in non-small cell lung cancer (NSCLC). Lepidic predominant subtype is a particular form of invasive lung adenocarcinoma, developed initially from Club cells and/or type II pneumocytes .The alveolar spreading induces a specific clinical and radiological presentation, with dyspnea, cough, ground-glass attenuations and alveolar. The Liebow definition held its stature until 2004 when the World Health Organization (WHO) publication on the tumors of the lung, pleura, thymus, and heart redefined bronchioloalveolar carcinoma as adenocarcinoma with a lepidic growth pattern along alveolar walls without stromal, vascular, or pleural invasion In conclusion, invasive component size, excluding lepidic growth, has a higher predictive value for pathologic malignant behavior and prognosis than total tumor size and aids in selecting optimal candidates for adjuvant chemotherapy among patients with pathologic stage I lung adenocarcinoma