Discriminating between bronchiolar adenoma,adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung with CT |
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Affiliation: | 1. Department of Pathology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, China;2. Department of Radiology, The Second Hospital of Jilin University, Changchun, 130041 Jilin, China |
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Abstract: | PurposeTo identify computed tomography (CT) features that may help distinguish bronchiolar adenoma (BA) from lung adenocarcinomas in situ (AIS) and minimally invasive adenocarcinomas (MIA) among lung lesions presenting as ground-glass nodules (GGNs).Materials and methodsA total of 140 patients with GGNs confirmed by surgery and pathology, were reviewed retrospectively. There were 68 men and 72 women with a mean age of 64.3 ± 8.9 (SD) years (range: 31 – 85 years). The CT features of BA, AIS, and MIA were analyzed and compared. CT features, including percentage of solid component, maximum diameter of solid component, lesion density, location, margin, shape, pseudo-cavitation, calcification, ill-defined peripheral opacity, and air bronchogram, were analyzed using multivariate logistic regression and receiver operating characteristic curves.ResultsThere were 11/140 (7.9%) patients with BA (mean age, 67.7 ± 7.5 [SD]; range 45 – 77 years), 63/140 (45.0%) patients with AIS (mean age, 62.5 ± 8.6 [SD]; range 36 – 69 years) and 66/140 (47.1%) patients with MIA (mean age, 63.5 ± 7.9 [SD]; range 35 – 72 years). By comparison with AIS and MIA, significantly different CT features of BA included tumor size, solid component diameters, low CT attenuation of the ground-glass component, irregular shape, ill-defined peripheral opacity, pseudo-cavitation, and abnormal pulmonary vein. Ill-defined peripheral opacity (odds ratio, 1.060; 95% confidence interval [CI]: 1.020 – 1.380) and pseudo-cavitation (odds ratio, 1.236; 95% CI: 1.070 – 1.565) were variables independently associated with the diagnosis of BA.ConclusionCT provides morphological features that allow differentiating between BA and AIS-MIA among lung lesions presenting as GGNs. |
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Keywords: | Lung neoplasm Solitary pulmonary nodule Computed X ray Tomography Adenocarcinoma Pre-invasive AIS" },{" #name" :" keyword" ," $" :{" id" :" kw0040" }," $$" :[{" #name" :" text" ," _" :" adenocarcinomas in situ ALK" },{" #name" :" keyword" ," $" :{" id" :" kw0050" }," $$" :[{" #name" :" text" ," _" :" anaplastic lymphoma kinase BA" },{" #name" :" keyword" ," $" :{" id" :" kw0060" }," $$" :[{" #name" :" text" ," _" :" bronchiolar adenoma CT" },{" #name" :" keyword" ," $" :{" id" :" kw0070" }," $$" :[{" #name" :" text" ," _" :" computed tomography EGFR" },{" #name" :" keyword" ," $" :{" id" :" kw0080" }," $$" :[{" #name" :" text" ," _" :" epidermal growth factor receptor GGN" },{" #name" :" keyword" ," $" :{" id" :" kw0090" }," $$" :[{" #name" :" text" ," _" :" ground-glass nodules MIA" },{" #name" :" keyword" ," $" :{" id" :" kw0100" }," $$" :[{" #name" :" text" ," _" :" minimally invasive adenocarcinomas SD" },{" #name" :" keyword" ," $" :{" id" :" kw0110" }," $$" :[{" #name" :" text" ," _" :" standard deviation |
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