Cavitating adenocarcinoma of the lung

The characteristics and outcomes of resected adenocarcinoma with cavity formation were studied in 7 cases, which were 14.9% of all 47 resected adenocarcinomas in the past three years. Tumor size was less than 3 cm in diameter in 3 cases, 3 to 5 cm in 2 and more than 5 cm in 2. Cavities were multiple in 4 cases and single in 3. Cavities were divided into 4 types pathologically. 1. Central necrosis type: central ischemia was suspected. This type was observed in 2 cases that died due to cancer. 2. Cancer cell lining type: the inner wall of the cavity was lined by viable cancer cells without necrosis. The cause of this type may be detachment of the central portion of a papillary growth tumor without necrosis. One of three patients died from cancer. The others are alive without recurrence. 3. Bronchial expansion type: the inner wall was composed of cancer cells and bronchus. This may be caused by ectatic change of peripheral bronchi following tumor invasion to more central bronchi. One of this type of case died due to myocardial infarction. 4. Alveolar expansion type: the inner wall was composed of cancer cells and alveoli. Detachment of destroyed alveoli or invasion along the wall of cavities of a honeycomb lung was suspected as a possible cause. One of this type of case is alive. Cavity formation can occur in adenocarcinoma even when the tumor is small. However there were few inflammatory related findings in adenocarcinoma with cavity formation. The outcome of the central necrosis type was especially poor, suggesting rapid tumor growth.