Lung Adenocarcinoma Spiculated Mass MCQ — NEET PG Practice Question | NEETPGAI
Lung Adenocarcinoma Spiculated Mass
medium
stethoscope Medicine
A 58-year-old never-smoker woman presents with a 3-week history of persistent dry cough. High-resolution CT chest reveals a 15 mm peripheral spiculated mass in the right upper lobe with radiating fibrous strands (corona radiata sign), as marked **A** in the diagram. There is no central cavitation. Which of the following histological subtypes is this radiological appearance most consistent with?
A. Lung adenocarcinoma
B. Large cell carcinoma
C. Squamous cell carcinoma of lung
D. Small cell lung cancer
Explanation
Why Lung adenocarcinoma is right
The spiculated peripheral pulmonary mass marked A with corona radiata sign (radiating fibrous strands) is a classic radiological hallmark of lung adenocarcinoma. Adenocarcinoma is now the most common histological subtype of lung cancer worldwide, including in never-smokers and women. It characteristically arises peripherally from terminal bronchioles or alveolar lining, and the spiculation pattern reflects desmoplastic stromal reaction and pleural involvement. The absence of central cavitation further supports adenocarcinoma over squamous cell carcinoma (WHO Classification of Thoracic Tumours 5th ed; NCCN NSCLC Guidelines 2026).
Why each distractor is wrong
Squamous cell carcinoma of lung: Squamous cell carcinoma typically presents as a CENTRAL, CAVITATING lesion with a strong association to smoking history. The peripheral, non-cavitating spiculated appearance is atypical for squamous histology.
Small cell lung cancer: Small cell carcinoma typically presents as a CENTRAL hilar or mediastinal mass with rapid growth and early nodal involvement. Peripheral spiculated nodules are not characteristic of SCLC.
Large cell carcinoma: Large cell carcinoma is a diagnosis of exclusion (no glandular or squamous differentiation) and does not have a characteristic peripheral spiculated appearance. It is also rare (<5% of lung cancers) and is not the expected diagnosis for this radiological pattern.
