CONTEXT: Adenocarcinoma already comprises half the cases of lung cancer.\nIts insidious clinical evolution contributes to the fact that, in absolute numbers,\nlung tumor is the cancer with the highest mortality in the world. When\nstill in situ , the adenocarcinoma is even quieter, making its typical presentation\non the computerized tomography of an irregular semisolid nodule smaller\nthan 3.0 cm. It is often diagnosed in a finding of examination in an asymptomatic\npatient. The prevalence of in situ adenocarcinoma (ISA) is less than\n5% of pulmonary malignancies and its radiological presentation with a diffuse\nmosaic paving pattern is even more unusual, mimicking other conditions\nmore frequent to this finding. CASE REPORT: We describe the case of a\n44-year-old male patient with a history of chronic smoking admitted to the\nemergency room at a referral hospital in SÃ?£o Paulo on 12/16/2016 with a\ncomplaint of progressive dyspnea associated with dry cough for 3 months, intermittent\nfever and weight loss of 8 kg in 2 months. A chest X-ray and computed\ntomography showed discrete focal points of peribroncovascular consolidation,\npredominantly central, areas with frosted glass attenuation associated\nwith smooth thickening of the interlobular septa, sometimes interspersed\nwith areas of preserved parenchyma, giving an aspect of ââ?¬Å?crazing pavingââ?¬Â\nwith diffuse distribution by the pulmonary parenchyma. The patient underwent\na biopsy with the anatomicopathological diagnosis of primary Adenocarcinoma\nin situ of the lung. CONCLUSION: We emphasize that the\nââ?¬Å?crazing pavingââ?¬Â of adenocarcinoma in situ pulmonary should be considered\nand known by the radiologist, because although isolated it is a rare condition,\nits early distrust in cases of atypical evolution of the most common injuries\ncan avoid a diagnosis in phases more advanced and higher mortality.
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