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Updated: Apr 23, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Lung cancer associated with cystic airspaces
Mario Mascalchi1, Domenico Attinà, Elena Bertelli
1From 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.
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.
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