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Pulmonary GGO Nodules Are Often Lung Cancer

March 8, 2009
Written by: , Filed in: Chest Radiology
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Prior studies have demonstrated that persistent ground-glass opacity (GGO) nodules are often bronchoalveolar cell carcinoma, atypical adenomatous hyperplasia, pulmonary lymphoproliferative disorder, or due to organizing pneumonia/fibrosis.

The objective of the study reported in Radiology was to evaluate CT features of GGO nodules with histopathologic findings. Fifty-three GGO nodules were evaluated histopathologically.

The study reported 68% of the nodules were bronchoalveolar cell carcinoma; 7% percent were adenocarcinoma with predominant bronchoalveolar cell carcinoma component; 6% percent, were atypical adenomatous hyperplasia; and 19 % were nonspecific organizing pneumonia/fibrosis.

Multiple nodules were seen in 22% of bronchoalveolar cell carcinoma or adenocarcinoma with predominant bronchoalveolar cell carcinoma component cases, 67% of atypical adenomatous hyperplasia cases, and 20% of nonspecific organizing pneumonia/fibrosis cases.

Interestingly, no significant differences in the anatomic CT characteristics of nodules were seen between the different histopathologic diagnoses, and no significant differences regarding the presence or absence of symptoms, smoking history, or cancer history were  seen between the different histopathologic diagnoses.

In the patients who had a PET scan, all of the nodules were characterized as negative. Comparing serial CTs, (a mean of 10 months between CT scans prior to resection), the majority of nodules showed no change in size.  However, two demonstrated a greater than 5 mm increase, and five demonstrated less than or equal to 5 mm increase in size.

Of the nodules that grew, one which grew greater than 5 mm was inflammatory and not malignant.

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The results show that approximately 75 percent of persistent GGO nodules are due to bronchoalveolar cell carcinoma or adenocarcinoma with predominant bronchoalveolar cell carcinoma component. There are no particular anatomic characteristics of these GGO nodules that allow differentiation from other histopathologic diagnoses.

Reference: Kim HY, Shim YM, et al. Persistent Pulmonary Nodular Ground-Glass Opacity at Thin-Section CT: Histopathologic Comparisons. Radiology 2007; 245 (October): 267-275.

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