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Review
. 2021 Jan;13(1):366-371.
doi: 10.21037/jtd-20-844.

Radiological imaging and pathological findings of small lung adenocarcinoma: a narrative review

Yukinori Sakao  1 , Hiroaki Kuroda  2 , Yuichi Saito  1 , Yoshikane Yamauchi  1 , Fumi Yokote  1 , Masufumi Kawamura  1 , Yasushi Yatabe  3
Affiliations
Review

Radiological imaging and pathological findings of small lung adenocarcinoma: a narrative review

Yukinori Sakao et al. J Thorac Dis. 2021 Jan.

Abstract

The eighth edition of the Lung Cancer Handling Regulations defines the pathological findings of "invasion" in the pathological diagnosis of lung adenocarcinoma and terms it as adenocarcinoma in situ/minimally invasive carcinoma. In addition, the invasion diameter (tumor diameter excluding the lepidic growth region) was adopted as the pT factor, and the classification further reflected prognosis (degree of invasion/progression). Meanwhile, computed tomography imaging-based classification, where the consolidation (nodule) diameter excluding the ground glass shadow area was defined as cT, and the classification reflected the pathological invasion diameter. It is clear that the revision of the eighth edition has reduced discrepancies in the pathological findings of lung adenocarcinoma in CT imaging and assessment of the degree of invasion and progression. At the same time, the 8th edition is not yet accurate enough. Therefore, we will discuss imaging techniques to better predict the extent of adenocarcinoma invasion and progression, based on our own findings and the literature.

Keywords: Small adenocarcinoma; mediastinal window setting; pathological classification; radiological imaging.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-844). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Comparison of HRCT images in lung (A1, B1) and mediastinal (A2, B2) window settings and the corresponding histopathological findings (A3, B3) of two independent lesions. In case A, pathological invasive size was close to CD (LD =23.0 mm, CD =11.0 mm, MD =2.7 mm, cT1bN0M0; pathological whole tumor size =18 mm, invasive size =10 mm, lepidic-predominant invasive adenocarcinoma, pT1aN0M0). In case B, pathological invasive size was close to MD (LD =32.8 mm, CD =13.6 mm, MD =4.2 mm, cT2aN0M0; pathological whole tumor size =25 mm, invasive size =4 mm, minimally invasive adenocarcinoma, pT1aN0M0). CD = consolidation dimension in the lung window setting; LD = whole-tumor dimension in the lung window setting; MD = tumor dimension in the mediastinal window setting. This figure cites from Lung Cancer 2016;95:51-56.
See this image and copyright information in PMC

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