Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11603

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    P2.07-008 - Radiological-pathological correlation for resected small lung nodules with pure ground glass opacity detected by high-resolution computed tomography (ID 989)

    09:30 - 09:30  |  Author(s): T. Yoshida
    • Abstract

    Background
    The term "ground glass opacity (GGO)" on high-resolution computed tomography (HRCT) is defined as “hazy increased attenuation in the lung that does not obliterate the bronchial and vascular margins” by Fleischner Society. The identification of small lung nodules of GGO on HRCT often implies lung cancer, especially well differentiated adenocarcinoma or atypical adenomatous hyperplasia; however, there is no objective definition of GGO, such as the computed tomography number.

    Methods
    A single institutional retrospective study. To access the correlation between radiological and pathological diagnosis of the patients with small pure GGO on HRCT. Thirty-nine consecutive surgically resected patients with pure GGO less than 30 mm detected by HRCT between July 2008 and March 2013 in our department were retrospectively examined. The median follow-up of these patients was 28.7 (1.9 - 92.7) months.

    Results
    The median age of the patients was 64 (range 42-82) years old, 19 patients were male and 20 were female. The median size of major axis of lung nodules was 11 (range 5-25) mm, and 29 (74.4%) were less than 15 mm and 10 were between 15 and 30 mm in diameter. Twenty-eight (71.8%) patients had a single nodule, whereas 11 patients had multiple nodules. Six of the 39 patients had a previous history of malignancy (three lung cancers and three other cancers). During the follow-up period, 22 patients had nodules that were stable in size or appearance, and five patients had nodules that either became enlarged or in which the opacity increased, as determined by HRCT. The other twelve patients were operated based on the findings of their first HRCT, basically by the attending surgeons’ decision. Partial resection was performed in seven patients, segmentectomy in 11 patients and lobectomy was performed in 21 patients. Histologically, thirty-seven patients had adenocarcinoma, one had small cell carcinoma and one had a benign tumor. Among the 37 patients with adenocarcinoma, 14 were adenocarcinoma in situ, five tumors were minimally invasive and 18 were invasive according to the IASLC/ATS/ERS classification. There was no postoperative recurrence during the follow-up period.

    Conclusion
    Even if the small pulmonary nodules present as pure GGO, they may still be adenocarcinoma with an invasive nature. The timing of surgery should be considered carefully so that a chance to achieve a cure of such patients is not missed.