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Original Research: Imaging |

Persistent Pure Ground-Glass Opacity Lung Nodules ≥ 10 mm in Diameter at CT ScanGround-Glass Opacity Nodules 00B3 10 mm in Diameter: Histopathologic Comparisons and Prognostic Implications

Hyun-ju Lim, MD; Soomin Ahn, MD; Kyung Soo Lee, MD; Joungho Han, MD; Young Mog Shim, MD; Sookyoung Woo, MS; Jae-Hun Kim, PhD; Miyeon Yie, MD; Ho Yun Lee, MD; Chin A. Yi, MD
Author and Funding Information

From the Department of Radiology and Center for Imaging Science (Drs Lim, K. S. Lee, Kim, Yie, H. Y. Lee, and Yi); the Department of Pathology (Drs Ahn and Han); the Department of Thoracic Surgery (Dr Shim); and the Samsung Biomedical Research Institute (Ms Woo), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Correspondence to: Kyung Soo Lee, MD, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea; e-mail: kyungs.lee@samsung.com


Funding/Support: This research was supported by the Korean Foundation for Cancer Research, Seoul, Korea [KFCR-CB-201103].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(4):1291-1299. doi:10.1378/chest.12-2987
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Background:  Little is known about the histopathology and prognosis of persistent pure ground-glass opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis.

Methods:  A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated.

Results:  The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram (P = .012), size of nodule (P = .032, cutoff = 16.4 mm in diameter), and mass of nodule (P = .040, cutoff = 0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size (P = .010) and mass of nodule (P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection.

Conclusions:  In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.

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