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Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography

View Article: PubMed Central - PubMed

ABSTRACT

Background: Lung nodules are being detected at an increasing rate year by year with high-resolution computed tomography (HRCT) being widely used. Ground-glass opacity nodule is one of the special types of pulmonary nodules that is confirmed to be closely associated with early stage of lung cancer. Very little is known about solitary ground-glass opacity nodules (SGGNs). In this study, we analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT.

Methods: A total of 95 resected SGGNs were evaluated with HRCT scan. The clinical, pathological, and radiological characteristics of these cases were analyzed.

Results: Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarcinoma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (all P<0.05).

Conclusion: We analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT and found that the size, density, shape, and pleural tag of SGGNs on HRCT are found to be the determinant factors of IA. In conclusion, detection of anaplastic lymphoma kinase expression and performance of PET/CT scan are not routinely recommended.

No MeSH data available.


Related in: MedlinePlus

Adenocarcinoma in situ in a 44-year-old woman.Notes: (A) A solitary ground-glass opacity nodule on the superior lobe of left lung was found at the time of her health checkup. She was a nonsmoker, did not have any individual history of cancer and no family history of cancer, and her blood tumor markers were negative. (B) On reexamination by HRCT after 3 months, no obvious change was noted. Hence, she decided to undergo surgical resection. Pathological diagnosis indicated that she had adenocarcinoma in situ. Immunohistochemistry: ALK-V (−), ROS-1 (−). (C) Low-magnification (hematoxylin and eosin, original magnification ×40) photomicrograph demonstrates uniform cuboidal cell proliferation (arrows) involving thickened alveolar walls (lepidic tumor growth). (D) High magnification of (C) (original magnification ×200).Abbreviations: ALK, anaplastic lymphoma kinase; HRCT, high-resolution computed tomography.
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f1-tcrm-12-1445: Adenocarcinoma in situ in a 44-year-old woman.Notes: (A) A solitary ground-glass opacity nodule on the superior lobe of left lung was found at the time of her health checkup. She was a nonsmoker, did not have any individual history of cancer and no family history of cancer, and her blood tumor markers were negative. (B) On reexamination by HRCT after 3 months, no obvious change was noted. Hence, she decided to undergo surgical resection. Pathological diagnosis indicated that she had adenocarcinoma in situ. Immunohistochemistry: ALK-V (−), ROS-1 (−). (C) Low-magnification (hematoxylin and eosin, original magnification ×40) photomicrograph demonstrates uniform cuboidal cell proliferation (arrows) involving thickened alveolar walls (lepidic tumor growth). (D) High magnification of (C) (original magnification ×200).Abbreviations: ALK, anaplastic lymphoma kinase; HRCT, high-resolution computed tomography.

Mentions: Among the 81 patients with SGGNs, 12 (14.8%) had AIS (Figure 1A and B), 14 (17.3%) MIA (Figure 2A and B), and 55 (67.9%) IA (Figure 3A and B). The predominant histologic subtypes among 55 patients with IA were lepidic and acinar patterns (n=29, 52.7%) and five (9.1%) patients had papillary patterns. All patients had stage I lung cancer. However, the rate of expression of anaplastic lymphoma kinase (ALK-V) and ROS-1 performed by immunohistochemistry was positive in 2.5% (n=2) and 8.6% (n=7) patients, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%.


Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography
Adenocarcinoma in situ in a 44-year-old woman.Notes: (A) A solitary ground-glass opacity nodule on the superior lobe of left lung was found at the time of her health checkup. She was a nonsmoker, did not have any individual history of cancer and no family history of cancer, and her blood tumor markers were negative. (B) On reexamination by HRCT after 3 months, no obvious change was noted. Hence, she decided to undergo surgical resection. Pathological diagnosis indicated that she had adenocarcinoma in situ. Immunohistochemistry: ALK-V (−), ROS-1 (−). (C) Low-magnification (hematoxylin and eosin, original magnification ×40) photomicrograph demonstrates uniform cuboidal cell proliferation (arrows) involving thickened alveolar walls (lepidic tumor growth). (D) High magnification of (C) (original magnification ×200).Abbreviations: ALK, anaplastic lymphoma kinase; HRCT, high-resolution computed tomography.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
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getmorefigures.php?uid=PMC5036641&req=5

f1-tcrm-12-1445: Adenocarcinoma in situ in a 44-year-old woman.Notes: (A) A solitary ground-glass opacity nodule on the superior lobe of left lung was found at the time of her health checkup. She was a nonsmoker, did not have any individual history of cancer and no family history of cancer, and her blood tumor markers were negative. (B) On reexamination by HRCT after 3 months, no obvious change was noted. Hence, she decided to undergo surgical resection. Pathological diagnosis indicated that she had adenocarcinoma in situ. Immunohistochemistry: ALK-V (−), ROS-1 (−). (C) Low-magnification (hematoxylin and eosin, original magnification ×40) photomicrograph demonstrates uniform cuboidal cell proliferation (arrows) involving thickened alveolar walls (lepidic tumor growth). (D) High magnification of (C) (original magnification ×200).Abbreviations: ALK, anaplastic lymphoma kinase; HRCT, high-resolution computed tomography.
Mentions: Among the 81 patients with SGGNs, 12 (14.8%) had AIS (Figure 1A and B), 14 (17.3%) MIA (Figure 2A and B), and 55 (67.9%) IA (Figure 3A and B). The predominant histologic subtypes among 55 patients with IA were lepidic and acinar patterns (n=29, 52.7%) and five (9.1%) patients had papillary patterns. All patients had stage I lung cancer. However, the rate of expression of anaplastic lymphoma kinase (ALK-V) and ROS-1 performed by immunohistochemistry was positive in 2.5% (n=2) and 8.6% (n=7) patients, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Lung nodules are being detected at an increasing rate year by year with high-resolution computed tomography (HRCT) being widely used. Ground-glass opacity nodule is one of the special types of pulmonary nodules that is confirmed to be closely associated with early stage of lung cancer. Very little is known about solitary ground-glass opacity nodules (SGGNs). In this study, we analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT.

Methods: A total of 95 resected SGGNs were evaluated with HRCT scan. The clinical, pathological, and radiological characteristics of these cases were analyzed.

Results: Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarcinoma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (all P<0.05).

Conclusion: We analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT and found that the size, density, shape, and pleural tag of SGGNs on HRCT are found to be the determinant factors of IA. In conclusion, detection of anaplastic lymphoma kinase expression and performance of PET/CT scan are not routinely recommended.

No MeSH data available.


Related in: MedlinePlus