A multicystic tumor-like lesion was detected in the left lung of a 76-year-old man. The lesion overlapped with a high uptake spot on PET (6.53 of SUVmax) (Picture 1A and B). The lesion in the resected left lower lobe (surrounded by arrows in Picture 2A) represented irregularly shaped multilocular emphysematous cysts with thick fibrous walls covered with multi-layered cancer cells (Picture 2B-D). The lesion was bordered by mildly emphysematous lung tissue (upper part of Picture 2C and D). Another specimen showed a cancer cell nest of keratinizing squamous cell carcinoma (diameter: 3 mm) with intercellular bridges that was spreading along the walls of the emphysematous cysts (Picture 3 and inset). This growth pattern imitated the lepidic growth observed in adenocarcinoma and squamous cell carcinoma (1,2). Although this case involved invasive squamous cell carcinoma and not carcinoma in situ, the emphysematous cyst-lining pattern of cancer cells and the CT pattern were quite characteristic.
Picture 1.
Picture 2.
Picture 3.
The authors state that they have no Conflict of Interest (COI).
References
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