Early-stage Lung Cancer by Xiangpeng Zheng Ming Li & Guozhen Zhang

Author:Xiangpeng Zheng, Ming Li & Guozhen Zhang
Language: eng
Format: epub
Publisher: Springer Singapore, Singapore

In comparison to other types of NSCLC, the pseudocavitation sign has preference for adenocarcinomas, especially early-stage diseases. In a report from Tailor et al., the overall incidence of pseudocavitation in lung tumors was approximately 14.6%, and more than four fifths were associated with adenocarcinoma [4]. Obviously, this was reflected in the statistical analysis with a significant difference (p value, 0.007). Subgroup analysis by histology validated that adenocarcinoma had higher frequency (about four times) than other types of lung cancer in manifestation of pseudocavitation. Hence, a calculated specificity of the pseudocavitation for differential diagnosis of adenocarcinoma was 0.94. Considering the low sensitivity (0.22), radiologists should be aware that the absence of pseudocavitation cannot rule out the diagnosis of adenocarcinoma.

Histologically, pseudocavitation reflects the lepidic growth pattern, i.e., the propensity of tumor cells growing along alveolar walls without disrupting lung architecture and resultant residual air spaces or air bronchograms, which may be accentuated by fibrotic contraction. In contrast, since nonlepidic growth commonly causes compression or obliteration of small airways or airspaces, pseudocavitation in nonlepidic adenocarcinomas is an uncommon finding [5]. Hence, pseudocavitation may be considered as a potential predictor of lepidic growth as well as favorable prognosis correspondingly.

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