ĐÁNH GIÁ NỐT PHỔI DẠNG KÉN THEO LUNG‑RADS 2022: BÁO CÁO CA BỆNH SINH THIẾT XUYÊN THÀNH NGỰC DƯỚI HƯỚNG DẪN CẮT LỚP VI TÍNH

Abstract

Cystic pulmonary nodules are rare lesions with complex imaging features that may be confused with both benign and malignant conditions. Lung-RADS 2022 has updated the evaluation and classification criteria for cystic lesions, standardizing follow-up protocols and facilitating early lung cancer detection. We report a case of a female patient, 73 years old, in whom a cystic pulmonary nodule was detected during CT-based lung cancer screening. The lesion was initially categorized as Lung-RADS 4A and monitored with LDCT after 3 months according to guideline recommendations. As the nodule remained unchanged, it was subsequently reclassified as Lung-RADS 3. Although the patient was advised to continue LDCT surveillance at 6 months, she opted for a diagnostic biopsy due to significant anxiety. CT-guided transthoracic needle biopsy revealed lepidic-predominant adenocarcinoma. This case highlights the application of Lung-RADS 2022 in the assessment of cystic lung nodules and demonstrates the role of CT-guided transthoracic biopsy. The procedure provided high diagnostic accuracy and enabled early treatment decisions. The integration of Lung-RADS 2022 classification with CT-guided transthoracic biopsy improves diagnostic effectiveness and supports individualized management of cystic pulmonary nodules. Although the initial management adhered to Lung-RADS 2022 recommendations, an early biopsy performed during follow-up led to the diagnosis of early-stage lung cancer. Adherence to standardized guidelines helps minimize unnecessary interventions but clinical management should be individualized to avoid missing cancers at an early stage.