title: Lung cancer associated with cystic airspaces.
abstract: OBJECTIVE
  The objectives of this study were to determine the frequency of lung cancers associated with a discrete cystic airspace and to characterize the morphologic and pathologic features of the cancer and the cystic airspace.
  
  
  METHODS
  We reviewed all diagnosed cases of lung cancer resulting from baseline screening (n=595) and annual screening (n=111) in the International Early Lung Cancer Action Program to identify those abutting or in the wall of a cystic airspace. We also reviewed the pathologic specimens.
  
  
  RESULTS
  A total of 26 lung cancers were identified abutting or in the wall of a cystic airspace. Of these, 13 were identified at baseline (13/595, 2%) and 13 at annual screening (13/111, 12%), which was significant (p<0.0001). The median circumferential portion of wall involved was less for the annual cancers than for the baseline ones, but this difference did not reach significance (90° vs 240°, p=0.07). The diagnosis was adenocarcinoma in all but three cases. Histologic analysis showed that the cystic space was a bulla, a fibrous walled cyst without a defined lining, or a pleural bleb and that in all but one case, the tumor was eccentric relative to the airspace and the wall of the airspace was unevenly thickened.
  
  
  CONCLUSIONS
  At annual repeat CT screening, the finding of an isolated cystic airspace with increased wall thickness should raise the suspicion of lung cancer.
authors.affiliation: Department of Radiology, Mount Sinai School of Medicine, One Gustave L. Levy Pl, Box 1234, New York, NY 10029, USA.
authors.forename: Ali O
authors.initials: AO
authors.lastname: Farooqi
authors.forename: Matt
authors.initials: M
authors.lastname: Cham
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhang
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Beasley
authors.forename: John H M
authors.initials: JH
authors.lastname: Austin
authors.forename: Albert
authors.initials: A
authors.lastname: Miller
authors.forename: Javier J
authors.initials: JJ
authors.lastname: Zulueta
authors.forename: Heidi
authors.initials: H
authors.lastname: Roberts
authors.forename: Cole
authors.initials: C
authors.lastname: Enser
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Kao
authors.forename: M K
authors.initials: MK
authors.lastname: Thorsen
authors.forename: James P
authors.initials: JP
authors.lastname: Smith
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Libby
authors.forename: Rowena
authors.initials: R
authors.lastname: Yip
authors.forename: David F
authors.initials: DF
authors.lastname: Yankelevitz
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Henschke
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D003560:Cysts / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed