Figure 6.

(A,B) A 53-year-old man with known COPD was referred for further work-up to the pulmonologist for complaints of persistent fatigue and weight loss. Axial chest CT in lung window setting (A) showed a large cystic airspace in the right lower lobe, surrounded by a thick heterogeneous wall of consolidation, with focal areas of asymmetry and a more nodular aspect. The lesion has a type III morphology according to the classification system by Mascalchi. Axial images in mediastinal window setting (B) show large heterogeneous adenopathies in the right hilar region and subcarinal area. Diagnosis of stage IV lung cancer (adenocarcinoma) was made, with bone and adrenal metastases (not shown). (C,D) A 62-year-old woman with previous history of squamous cell carcinoma of the tongue base and stage I adenocarcinoma in the left lower lobe, presented on coronal images during follow-up with a cystic airspace with small rather endophytic nodular component (white arrow) (C). Chest CT study 9 months later (D) shows changes in lesion morphology from type II to predominant type III lesion, according to Mascalchi, with slight decrease of the cystic airspace size and overall increase of the diffuse wall thickening. COPD, chronic obstructive pulmonary disease; CT, computed tomography.