This 67-years old woman came with cough and fever and a radiograph showing an opacity in the left upper and mid zones, simulating old tuberculosis.
On the CT, there is a dense lesion in the posterior segment of the left upper lobe towards the apex with focal fibrosis that could perhaps be a post-infectious lesion. However more inferiorly, the lesion is subsolid.
Subsolid lesions like these are worrisome. This lesion is more than 8 mm in diameter and hence can either be excised or can undergo a CT guided biopsy, which we did.
It has been diagnosed to be a mucinous invasive adenocarcinoma with lepidic spread…we would have called this bronchoalveolar carcinoma in the olden days.
Moral: Don’t ignore subsolid lesions, especially the ones larger than 8 mm.
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