CT features of lung adenocarcinomas presenting as groundglass opacity and the correlation of the proportion of consolidation with pathological invasiveness Poster No.:
C-0082
Congress:
ECR 2014
Type:
Scientific Exhibit
Authors:
L. P. QI, X.-P. Zhang, Y.-S. Sun, L. Tang, Y. Cui; Beijing/CN
Keywords:
Lung, Oncology, Thorax, CT-High Resolution, CT, Computer Applications-General, Cancer
DOI:
10.1594/ecr2014/C-0082
Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myESR.org
Page 1 of 10
Aims and objectives To investigate the CT features of lung adenocarcinas presenting as GGO and the correlation of the proportion of the consolidation with pathological invasiveness.
Methods and materials Fifty-nine adenocarcinomas presenting as GGO on CT were retrospectively studied. All the patients were scanned with 64-row spiral CT.Thin-slice and small FOV images of focal lesions were reconstructed with thickness1.25mm, DFOV 15-20cm.CT features of lesions were analyzed on thin-slice images. The maximal diameter of the consolidation area (Cdmax) and the tumor(Td) was measured on axial section. The ratio of consolidation to the whole lesion was computed: R= Cdmax/ Td. The cases were classified into two groups,GG (R#0.5)and GS (R#0.5). Two senior pathologists reviewed all the sections in consult and made pathological diagnosis and pTNM staging. Images for this section:
Page 2 of 10
Fig. 1: showing the method of measurement of Cdmax(the short thick line)and Td (the thin line).The ratio of consolidation to the whole lesion was computed: R= Cdmax/ Td.
Page 3 of 10
Results There were twenty males and thirty-nine females. The mean size of the lesions was 27.1mm. Thirty-seven cases had no respiratory symptoms and masses were detected when underwent chest physical examination.Twenty-two cases had symptoms of cough, sputum, hemoptysis and chest pain. There were eight pure GGOs and fiftyone mixed GGOs. Most lesions were round and oval but 22%#13/59# of tumors were irregular or polygonal. Malignant features of lobulation and/or spiculation and pleural indentation often occurred, being 83.1%#49/59##72.9%#43/59# respectively. Bubblelike low attenuation appeared in 72.9%#43/59#cases. Most lesions had clear margin of larger than 50% circumference of tumor. Nineteen cases were classified into GG and forty cases were classified into GS. There are more lesions with smooth margin in GG. The sign of bubble-like attenuation and pleural indentation were more common in GS. There were more cases with lymph node metastasis and pleural invasion in GS than GG. pTNM staging of GS were more advanced than that of GG. Images for this section:
Page 4 of 10
Fig. 1: showing the method of measurement of Cdmax(the short thick line)and Td (the thin line).The ratio of consolidation to the whole lesion was computed: R= Cdmax/ Td.
Page 5 of 10
Fig. 2: A 56 years old female patient, a pGGO lesion was found with physical examnation.CT showed the lesion with clear margin and lobulation.
Page 6 of 10
Fig. 3: The same patient adenocarcinoma(x200).
of
figure
2.Pathological
diagnosis
was
acinus
Page 7 of 10
Fig. 4: A 61 year-old male, CT found right upper lesion of mixed GGO. The lesion displayed typical malignant features of spiculation, lobulation and pleural indentation.And the lesion showed clear margin and bubble-like low area.
Page 8 of 10
Fig. 5: The pathological slice of figure 4:adenocarcinoma with acinus type(x200).
Page 9 of 10
Conclusion lung adenocarcinas presenting as GGO often demonstrated the common malignant features of lobulation#spiculation and pleural indentation. Bubble-like low attenuation and clear circumference were frequently seen. The proportion of consolidation to the whole lesion on HRCT is correlative to the pathological invasiveness of the mass and could be helpful for prognosis.
Personal information Li-Ping Qi#from Department of Radiology, Peking University Cancer Hospital & Institute. Specialized in chest imaging, diagnosis, staging and prognosis of lung cancer. e-mail:
[email protected] Telephone:+86-10-88196021
References
1.
2.
3.
4.
Tae Hoon Kim.Differential CT features of infectious pneumonia versus bronchioloalveolar carcinoma (BAC) mimicking pneumonia. Eur Radiol (2006) 16: 1763-1768 Ho Yun Lee, MD and Kyung Soo Lee, MD Ground-glass Opacity NodulesHistopathology, Imaging Evaluation, and Clinical Implications. J Thorac Imaging 2011;26:106-118 Suzuki K. Asamura H. Kusumoto M. Kondo H. Tsuchiya R. "Early" peripheral lung cancer: prognostic significance of ground glass opacity on thin-section computed tomographic scan.Annals of Thoracic Surgery. 74(5):1635-9, 2002 Ohde Y. Nagai K. Yoshida J. Nishimura M. Takahashi K. Suzuki K. Takamochi K. Yokose T. Nishiwaki Y. The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma. Lung Cancer. 42(3):303-10, 2003
Page 10 of 10
