Role of imaging biomarkers in mutation-driven non-small cell lung cancer

Figure 5 Lymphangitic carcinomatosis and pleural metastases in 26-year old male non-smoker with ROS1-positive non-small cell lung cancer. A: Pre-treatment computed tomography (CT) shows a dominant right lower lobe mass with diffuse bilateral, right greater than left, lymphangitic carcinomatosis characterized by nodular interstitial thickening and ground glass opacities; B: Pre-treatment CT (mediastinal window) shows right pleural nodular thickening and pleural effusion (arrowheads) consisted with pleural metastasis; C: Initial post-treatment CT shows marked interval response to targeted therapy with near complete resolution of right lower lobe mass and of lymphangitic carcinomatosis. Increased frequencies of lymphangitic carcinomatosis and pleural metastases have also been described in ALK-positive non-small cell lung cancer (Figure 2).