patient and review the literature. The tumor appeared as miliary mottling on chest radiographs. Papillary predominant adenocarcinoma is a subtype

of invasive adenocarcinoma demarcated by presence of papillary structures containing true fibro vascular cores which replaces the alveolar lining

or existing within the alveolar spaces. The fibrovascular cores are lined by cuboidal to columnar neoplastic cells. Papillary predominant

adenocarcinoma can be a diagnostic pitfall because of its deceptive clinical and radiological features that can mimic commoner non malignant

conditions like tuberculosis in a prevalent third world country like India. We have shown the role of cytology and small biopsy findings based on H

& E stain and applicability of newer WHO 2015 classification of lung cancer in early diagnosis of fatal pulmonary malignancy suitable for resource

constraints countries.