title: Lung cancer associated with cystic airspaces.
abstract: OBJECTIVE
  This study aimed to define computed tomographic morphologic features of lung cancer associated with cystic airspaces, their modifications in serial computed tomographic scans, and 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography uptake.
  
  
  METHODS
  Computed tomographic scans and 18F-FDG positron emission tomography in 24 patients with lung cancer (17 adenocarcinomas, 7 squamous cell carcinomas, 12 stage I and 12 stage II to IV) associated with cystic airspaces were reviewed.
  
  
  RESULTS
  Mean diameter of airspace was initially 17.6 mm (range, 5-30 mm), and 4 morphologic patterns were recognized: solid nodule protruding externally (type I, n = 5) or internally (type II, n = 4) from the cyst wall; circumferential thickening of the cyst wall (type III, n = 8); and tissue intermixed within clusters of cysts (type IV, n = 7). With tumor growth, airspace size decreased in 9, increased in 6, and was unchanged in 9 cases. Five cases evolved from type III to type I, and 5 lesions became completely solid. 18F-fluoro-2-deoxy-D-glucose uptake was initially absent to mild in 7 and moderate to marked in 14 lesions.
  
  
  CONCLUSIONS
  Progressive wall thickening or appearance/increase of a nodule inside or outside a cystic airspace should raise suspicion of lung cancer irrespective of FDG uptake.
authors.affiliation: From the *"Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence; †Quantitative and Functional Radiology Research Program at Meyer Children and Careggi Hospitals of Florence, Florence; ‡Cardio-Thoracic Radiology, Cardio-Thoracic-Vascular Department, Sant'Orsola-Malpighi University-Hospital, Bologna; §Nuclear Medicine Unit, "Le Scotte" University Hospital, Siena; ∥Division of Pneumonology, Careggi Hospital, Florence; and ¶Nuclear Medicine Department, Sant'Orsola-Malpighi University-Hospital, Bologna, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mascalchi
authors.forename: Domenico
authors.initials: D
authors.lastname: Attinà
authors.forename: Elena
authors.initials: E
authors.lastname: Bertelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Falchini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vella
authors.forename: Andrea Lopes
authors.initials: AL
authors.lastname: Pegna
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18