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Nodular ground-glass opacities on thin-section CT: size change during follow-up and pathological results.

Lee HJ, Goo JM, Lee CH, Yoo CG, Kim YT, Im JG - Korean J Radiol (2007 Jan-Feb)

Bottom Line: In each group, the change in size during the follow-up period, the pathological results and the rate of malignancy were evaluated.Mixed nodular GGOs (MNGGOs) had the potential for growth; most were pathologically adenocarcinoma or BAC.By contrast, PNGGOs were stable for several months to years; most were AAH, BAC, or focal interstitial fibrosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea.

ABSTRACT

Objective: To evaluate the inter-group differences in growth and the pathological results of nodular ground-glass opacities (GGOs) according to their size and focal solid portions.

Materials and methods: Ninety-six nodular GGOs in 55 individuals followed by CT for at least one month from an initial chest CT were included. Forty nodular GGOs in 30 individuals were pathologically confirmed to be: adenocarcinoma (n = 15), bronchioloalveolar carcinoma (BAC) (n = 11), atypical adenomatous hyperplasia (AAH) (n = 8), focal interstitial fibrosis (n = 5) and aspergillosis (n = 1). Lesions were categorized based on high-resolution CT findings: pure nodular GGO (PNGGO) < or = 10 mm, PNGGO > 10 mm, mixed nodular GGO (MNGGO) < or = 10 mm, and MNGGO > 10 mm. In each group, the change in size during the follow-up period, the pathological results and the rate of malignancy were evaluated.

Results: Three MNGGO lesions, and none of the PNGGO, grew during the follow-up period. Resected PNGGOs < or = 10 mm were AAH (n = 6), BAC (n = 5), and focal interstitial fibrosis (n = 1). Resected PNGGOs > 10 mm were focal interstitial fibrosis (n = 4), AAH (n = 2), BAC (n = 2), and adenocarcinoma (n = 2). Resected MNGGOs < or = 10 mm were adenocarcinoma (n = 2), and BAC (n = 1). Resected MNGGOs > 10 mm were adenocarcinoma (n = 11), BAC (n = 3), and aspergillosis (n = 1).

Conclusion: Mixed nodular GGOs (MNGGOs) had the potential for growth; most were pathologically adenocarcinoma or BAC. By contrast, PNGGOs were stable for several months to years; most were AAH, BAC, or focal interstitial fibrosis.

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Pure nodular ground-glass opacity in the right upper lobe confirmed as focal interstitial fibrosis in a 61-year-old man.A. Thin-section CT shows 30 mm pure nodular ground-glass opacity in the right upper lobe.B. On follow-up CT scan after seven months, an interval change was not noted. The lesion was pathologically confirmed by right upper lobectomy. On pathologic slides, focal interstitial fibrosis with exuberant type II pneumocyte proliferation and alveolar macrophage collection were found. The cause of the focalinterstitial fibrosis was not confirmed.
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Figure 4: Pure nodular ground-glass opacity in the right upper lobe confirmed as focal interstitial fibrosis in a 61-year-old man.A. Thin-section CT shows 30 mm pure nodular ground-glass opacity in the right upper lobe.B. On follow-up CT scan after seven months, an interval change was not noted. The lesion was pathologically confirmed by right upper lobectomy. On pathologic slides, focal interstitial fibrosis with exuberant type II pneumocyte proliferation and alveolar macrophage collection were found. The cause of the focalinterstitial fibrosis was not confirmed.

Mentions: Twelve lesions from the PNGGOs ≤ 10 mm, ten lesions from the PNGGO > 10 mm, three lesions from the MNGGO ≤ 10 mm and 15 lesions from the MNGGO > 10 mm were resected. The histological results and change of size in each group are presented in Table 2. The resected PNGGOs ≤ 10 mm were AAH (n = 6) (Fig. 1), BAC (n = 5), and focal interstitial fibrosis (n = 1). The resected PNGGOs > 10 mm were focal AAH (n = 2) (Fig. 2), BAC (n = 2), adenocarcinoma (Fig. 3) (n = 2) and interstitial fibrosis (n = 4) (Fig. 4). The resected MNGGOs ≤ 10 mm were adenocarcinoma (n = 2) and BAC (n = 1). The resected MNGGOs > 10 mm were adenocarcinoma (n = 11) (Fig. 5), BAC (n = 3) and aspergillosis (n = 1) (Fig. 6). Three lesions that had grown during the follow-up were histologically confirmed as adenocarcinoma with mixed acinar and bronchioloalveolar patterns. Among 15 adenocarcinomas, 13 lesions were histologically confirmed as well-differentiated or moderately-differentiated adenocarcinoma with mixed acinar and bronchioloalveolar types and two were as well-differentiated adenocarcinoma with bronchioloalveolar type.


Nodular ground-glass opacities on thin-section CT: size change during follow-up and pathological results.

Lee HJ, Goo JM, Lee CH, Yoo CG, Kim YT, Im JG - Korean J Radiol (2007 Jan-Feb)

Pure nodular ground-glass opacity in the right upper lobe confirmed as focal interstitial fibrosis in a 61-year-old man.A. Thin-section CT shows 30 mm pure nodular ground-glass opacity in the right upper lobe.B. On follow-up CT scan after seven months, an interval change was not noted. The lesion was pathologically confirmed by right upper lobectomy. On pathologic slides, focal interstitial fibrosis with exuberant type II pneumocyte proliferation and alveolar macrophage collection were found. The cause of the focalinterstitial fibrosis was not confirmed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2626694&req=5

Figure 4: Pure nodular ground-glass opacity in the right upper lobe confirmed as focal interstitial fibrosis in a 61-year-old man.A. Thin-section CT shows 30 mm pure nodular ground-glass opacity in the right upper lobe.B. On follow-up CT scan after seven months, an interval change was not noted. The lesion was pathologically confirmed by right upper lobectomy. On pathologic slides, focal interstitial fibrosis with exuberant type II pneumocyte proliferation and alveolar macrophage collection were found. The cause of the focalinterstitial fibrosis was not confirmed.
Mentions: Twelve lesions from the PNGGOs ≤ 10 mm, ten lesions from the PNGGO > 10 mm, three lesions from the MNGGO ≤ 10 mm and 15 lesions from the MNGGO > 10 mm were resected. The histological results and change of size in each group are presented in Table 2. The resected PNGGOs ≤ 10 mm were AAH (n = 6) (Fig. 1), BAC (n = 5), and focal interstitial fibrosis (n = 1). The resected PNGGOs > 10 mm were focal AAH (n = 2) (Fig. 2), BAC (n = 2), adenocarcinoma (Fig. 3) (n = 2) and interstitial fibrosis (n = 4) (Fig. 4). The resected MNGGOs ≤ 10 mm were adenocarcinoma (n = 2) and BAC (n = 1). The resected MNGGOs > 10 mm were adenocarcinoma (n = 11) (Fig. 5), BAC (n = 3) and aspergillosis (n = 1) (Fig. 6). Three lesions that had grown during the follow-up were histologically confirmed as adenocarcinoma with mixed acinar and bronchioloalveolar patterns. Among 15 adenocarcinomas, 13 lesions were histologically confirmed as well-differentiated or moderately-differentiated adenocarcinoma with mixed acinar and bronchioloalveolar types and two were as well-differentiated adenocarcinoma with bronchioloalveolar type.

Bottom Line: In each group, the change in size during the follow-up period, the pathological results and the rate of malignancy were evaluated.Mixed nodular GGOs (MNGGOs) had the potential for growth; most were pathologically adenocarcinoma or BAC.By contrast, PNGGOs were stable for several months to years; most were AAH, BAC, or focal interstitial fibrosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea.

ABSTRACT

Objective: To evaluate the inter-group differences in growth and the pathological results of nodular ground-glass opacities (GGOs) according to their size and focal solid portions.

Materials and methods: Ninety-six nodular GGOs in 55 individuals followed by CT for at least one month from an initial chest CT were included. Forty nodular GGOs in 30 individuals were pathologically confirmed to be: adenocarcinoma (n = 15), bronchioloalveolar carcinoma (BAC) (n = 11), atypical adenomatous hyperplasia (AAH) (n = 8), focal interstitial fibrosis (n = 5) and aspergillosis (n = 1). Lesions were categorized based on high-resolution CT findings: pure nodular GGO (PNGGO) < or = 10 mm, PNGGO > 10 mm, mixed nodular GGO (MNGGO) < or = 10 mm, and MNGGO > 10 mm. In each group, the change in size during the follow-up period, the pathological results and the rate of malignancy were evaluated.

Results: Three MNGGO lesions, and none of the PNGGO, grew during the follow-up period. Resected PNGGOs < or = 10 mm were AAH (n = 6), BAC (n = 5), and focal interstitial fibrosis (n = 1). Resected PNGGOs > 10 mm were focal interstitial fibrosis (n = 4), AAH (n = 2), BAC (n = 2), and adenocarcinoma (n = 2). Resected MNGGOs < or = 10 mm were adenocarcinoma (n = 2), and BAC (n = 1). Resected MNGGOs > 10 mm were adenocarcinoma (n = 11), BAC (n = 3), and aspergillosis (n = 1).

Conclusion: Mixed nodular GGOs (MNGGOs) had the potential for growth; most were pathologically adenocarcinoma or BAC. By contrast, PNGGOs were stable for several months to years; most were AAH, BAC, or focal interstitial fibrosis.

Show MeSH
Related in: MedlinePlus