Multifocal adenocarcinoma: perspectives, assumptions and elephants

In the 10/22/17 issue of Thorax, Ruoyan Li and colleagues published an interesting analysis of 2 patients with multifocal adenocarcinoma (1). Both patients were non-smokers who presented with multiple (n=7 and 8) ground glass nodules (GGNs) which were mostly resected and confirmed to be within the adenocarcinoma spectrum, ranging from premalignant lesions [atypical adenomatous hyperplasia (AAH)] to minimally invasive lesions [adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA)] and invasive adenocarcinoma (2 lesions in patient 2 were not resected). There was no lymph node involvement or lympho-vascular invasion in either case.