Some aspects of lung adenocarcinoma in radiological imaging

Adenocarcinoma is becoming an increasingly common histological type of lung neoplasms diagnosed nowadays. Some manifestations of this tumor are poorly known due to wide polymorphism of imaging lesions.The paper presents and discusses the examples of rare forms of lung adenocarcinoma in radiography and high resolution computed tomography (HRCT). A similarly wide spectrum of imaging lesions is found in alveolar cell carcinomas which are now included among the histological subtypes of adenocarcinoma. It is assumed that HRCT images of localized alveolar cell carcinoma forms are highly suggestive diagnostically. Recently, much attention has been focused on comparative HRCT and histopathological studies of peripheral adenocarcinoma nodules < 2 cm. It has been demonstrated that small nodules of adenocarcinoma characterized by 'ground-glass' HRCT images and slow growth are in situ lesions with good prognosis. Moreover, serial CT examinations showed that in cases of nodule progression, evolution from pure 'ground-glass' forms through mixed changes to full consolidation can be observed. This is associated with transformation of the lesion into its invasive histological form and rapid growth. The paper discusses also the causes of diagnostic errors in early forms of lung neoplasms, particularly of adenocarcinomas. Good prospects of early diagnosis and improvement of treatment results are associated with CT screening of lung neoplasms. (author)