Lung cancer is the leading cause of cancer mortality worldwide. Adenocarcinoma is the most frequent pulmonary malignancy in most parts of the world. The papillary predominant subtype is applied when more than 75% of the tumor has the papillary architecture in histopathology. This subtype consists of about one-tenth of pulmonary adenocarcinomas. A 27-year-old man was referred with the history of dyspnea for the past three months. The patient had a diagnosis of right pulmonary empyema and was on medical treatment. After non-response he underwent surgery. The pathologist reported papillary adenocarcinoma of the lung, moderately differentiated with pleural involvement. Immunohistochemistry confirmed the diagnosis. Correct diagnosis of this subtype in histopathology is necessary for the determination of prognosis, cytogenetic changes, and selecting best treatment modalities.

Keywords: Papillary adenocarcinoma, Lung, Youth

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