Lung cancer associated with cystic airspaces - Current concept, pathogenesis, imaging features, pathological basis, and management

Sep 22, 2026

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This narrative review summarizes the current concept, CT imaging features, pathologic basis, and the correlation between imaging and pathology in lung cancer associated with cystic airspaces (LCCAs). LCCA is a distinct lung cancer subtype with unique imaging and pathological characteristics. Although lung cancer screening can detect cystic lesions, separating benign from malignant disease remains challenging. Pathologic varieties differ, and early diagnosis with accurate identification is clinically valuable for patient management and prognosis improvement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Keywords

Introduction

Lung cancer burden and low-dose CT screening

Differential diagnosis of sub-solid nodules

Cystic airspaces and the rationale for LCCA focus

Lung cancer associated with cystic airspaces: Current concept, pathogenesis, imaging features, pathological basis, and management Science Progress Vol. 109(2): 1–11 © The Author(s) 2026 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions) [DOI: 10.1177/00368504261448599](DOI: 10.1177/00368504261448599) [journals.sagepub.com/home/sci](journals.sagepub.com/home/sci) Xin Xu1,2,*, Jidong Guo3,4,5,*, Rihua Hu6,*, Wenxin Yuan7, and Longhua Sun1,8,9 Abstract This narrative review summarizes the current concept, CT imaging features, pathologic basis, and the correlation between imaging and pathology in lung cancer associated with cystic airspaces (LCCAs). Lung cancer associated with cystic airspacesis a distinct subtype of lung cancer with unique imaging and pathological features. Lung cancer screening can identify patients with cystic lesions on imaging, but distinguishing benign from malignant lesions remains challenging. The pathologic types of LCCAs vary, and early diagnosis and accurate identification are of great clinical value for patient management and improved prognosis. Clinicians should pay more attention to LCCAs to promote early diagnosis, improve the timing of interventions, and achieve better survival benefits for patients. Keywords lung cancer, CT imaging, pathology, diagnosis, treatment Received: 27 January 2026; Revised: 31 March 2026; Accepted: 21 April 2026 1. Introduction Lung cancer is one of the malignant tumors with the highest morbidity and mortality rates worldwide. 1 The latest data show that the incidence of lung cancer is gradually increasing, and the mortality rate of lung cancer has exceeded that of breast cancer, making lung cancer the leading cause of death from tumor-related diseases.2,3 Lung cancer is a significant problem affecting public health, imposing a heavy burden on the government healthcare system and the socio-economy. In the past decade or so, with the development and widespread use of low-doseCT, many extensive cohort studies have determined that low-dose CT screening can increase the diagnosis and treatment of lung cancer in its early stages, thereby reducing lung 1Department of Pulmonary and Critical Care Medicine, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, P. R. China 2Clinical Medicine, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, P. R. China 3Guangzhou Panyu Center for Disease Control and Prevention (Guangzhou Panyu Health Supervision Institute, Guangzhou, Guangdong, P. R. China 4School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, P. R. China 5Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang, P. R. China 6Department of Breast Surgery, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, P. R. China 7Department of Ultrasonography, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 8Jiangxi Hospital of China-Japan Friendship Hospital, Nanchang, Jiangxi, P. R. China 9Jiangxi Clinical Research Center for Respiratory Diseases, Nanchang, Jiangxi, P. R. China *Jidong Guo, Rihua Hu, contributed equally with the first author. Corresponding author: Longhua Sun, Department of Pulmonary and Critical Care Medicine, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yong Wai Zheng Street, Donghu District, Nanchang, Jiangxi 330006, P.R. China. Email: [ndyfy05715@ncu.edu.cn](ndyfy05715@ncu.edu.cn) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided

FAQs

What is lung cancer associated with cystic airspaces (LCCA) in this review?

LCCA is described as a distinct subtype of lung cancer with unique imaging and pathological features.

Why is distinguishing benign from malignant cystic lesions difficult?

Screening can identify cystic lesions on imaging, but differential diagnosis between benign and malignant lesions remains challenging, especially in early stages.

What is the clinical significance of early diagnosis and accurate identification of LCCA?

Early diagnosis and correct identification are of great clinical value for patient management and can improve prognosis.

Sep 22, 2026

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