Lung Cancers Associated with Cystic Airspaces

Lung cancer, the second most common malignancy in both men and women, poses a significant health burden. Early diagnosis remains pivotal in reducing lung cancer mortality. Given the escalating number of computed tomography (CT) examinations in both outpatient and inpatient settings, radiologists play a crucial role in identifying early-stage pulmonary cancers, particularly non-nodular cancers. Screening programs have been instituted to achieve this goal, and they have raised attention within the scientific community to lung cancers associated with cystic airspaces. These cancers, although they have been known for at least a decade, remain understudied. Limited investigations with small sample sizes have estimated their prevalence and explored their radiological and pathological features. Lung cancers associated with cystic airspaces exhibit varying complexities within their cystic components and demonstrate suspicious changes over time. Adenocarcinoma is the predominant histological type, often with a peripheral location. Differential diagnosis on CT scans includes inflammatory processes or emphysema-related changes. Unfortunately, prospective studies specifically analyzing the prevalence of cystic airspace-associated lung cancers are lacking. However, it is estimated that they constitute approximately one-fourth of delayed radiological diagnoses. Increased awareness among radiologists could lead to more timely identification and potentially reduce lung cancer mortality in a cost-effective manner.