Abstract:Cystic lung cancer is a type of lung cancer characterized by cystic spaces on imaging. Its pathological type is mainly adenocarcinoma，and its molecular features include driver gene mutations such as EGFR and KRAS. Imaging classification systems are various. In recent years，classification methods based on cyst wall thickness，nodule distribution，and dynamic evolution of the cystic spaces have gradually improved，but no standardization consensus has been reached. New technologies such as magnetic resonance imaging，positron emission tomography/computed tomography（PET/CT），and photon-counting CT have shown potential in differential diagnosis， although their sensitivity is limited. Treatment mainly consists of surgery combined with targeted therapy and immunotherapy，and prognosis is closely related to imaging classification and molecular heterogeneity. This article reviews the imaging manifestations and clinical diagnosis and treatment of cystic lung cancer，and analyzes its clinical challenges and future research directions.