Fig. 5.

Low-dose CT images show both an increase in size and density of a scar-like lesion of the left lung apex, consisting of a lung adenocarcinoma. (a, c) Axial and coronal LDCT sections of the left apex show an irregular subpleural opacity that was interpreted as apical fibrotic changes. (b, d) LDCT repeated at a 1-year interval shows spiculations (arrowhead) and a significant thickening of the lesion (arrow). A PET/CT scan was positive and the patient went to lobectomy with histologic diagnosis of adenocarcinoma. Lung cancers presenting as fibrotic changes or as scar-like lesions are relatively uncommon but could be encountered in LDCT screening