Title : Assisted incidental detection of cancerous lung nodule in Argentina: A case of adenosquamous carcinoma identified via chest X-ray AI and qTrack
Abstract:
Introduction: Lung cancer is the leading cause of cancer mortality globally, with most cases diagnosed at advanced stages. In Latin America, limited access to structured screening makes AI-integrated diagnostic tools a pragmatic pathway for early detection. qXR (Qure.ai) is a CE-marked, FDA-cleared deep learning algorithm for automated chest radiograph analysis for lung nodule. qTrack enables longitudinal nodule tracking and multidisciplinary coordination for pulmonary nodule management. We present a case where this AI workflow led to curative surgery for early-stage lung cancer in an Argentina.
Case Presentation: A 65-year old non-smoking woman presented to Hospital Córdoba for routine imaging. qXR flagged bilateral pulmonary nodules, with a dominant spiculated left upper lobe nodule requiring urgent follow-up; patient navigator used qTrack to coordinate next steps for nodule management. PET-CT (November 2025) confirmed a hypermetabolic left upper lobe nodule (SUVmax 7, 18 mm, apicoposterior segment) and a second hypermetabolic right lower lobe nodule (SUVmax 5, 14 mm), with no mediastinal nodal uptake. CT-guided biopsy (December 2025) demonstrated an invasive malignant epithelial neoplasm with marked nuclear atypia; immunohistochemistry (p63, TTF-1) indicated probable squamous cell carcinoma. The patient underwent left upper lobectomy (March 2026). Final histopathology revealed poorly differentiated adenosquamous carcinoma G3 (2.1 cm). Surgical resection margins were clear.
Discussion: qXR's detection of a high-suspicion nodule triggered a diagnostic cascade culminating in stage IA3 lung cancer resection with clear margins and node-negative disease. An outcome unlikely without AI prioritisation in a busy public hospital. Adenosquamous carcinoma represents <4% of all lung carcinomas and carries a worse prognosis than either pure subtype; the dual IHC profile (TTF-1+/p63+) confirmed mixed lineage. Despite the adverse prognostic significance of STAS, node-negative status and clear surgical margins confer a favourable outlook. qTrack was critical in preventing loss to follow-up across radiology, pulmonology, thoracic surgery, and pathology and ensuring the patient gets a curative surgery in time.
Conclusion: AI assisted chest radiograph analysis (qXR) for incidental nodule detection and nodule tracking (qTrack) enabled curative resection of an early-stage adenosquamous lung carcinoma (pT1c pN0) in a non-smoking Argentine woman. This case supports the role of AI radiology tools in detecting incidental early stage lung cancers and reducing diagnostic delays to improve Lung cancer outcomes in public health systems with limited health infrastructure.
