Duvuru Ram1, Holly Egan2, Tharumenthiran Ramanathan3. 1. Greenlane Cardiothoracic Unit, Auckland City Hospital, 2 Park Road, Grafton, Auckland, 1023, New Zealand. drram3508@gmail.com. 2. Department of Radiology, Auckland City Hospital, Auckland, New Zealand. 3. Greenlane Cardiothoracic Unit, Auckland City Hospital, 2 Park Road, Grafton, Auckland, 1023, New Zealand.
Abstract
BACKGROUND: The spectrum of ground glass opacity (GGO) is a diagnostic and clinical management quandary. The role of computed tomographic scans in detecting malignant GGO has inter-observer variability. Pure GGO have been traditionally thought to be predominantly benign in nature and has long volume doubling times. This study was undertaken to correlate the findings of radiology and histology of ground glass opacities at our institute. METHODS: This study is a retrospective observational study of patients who underwent lung resection surgery for radiology proven ground glass opacities between January 2010 and December 2018. A total of 115 patients were included in the study based on inclusion and exclusion criteria and were analysed. RESULTS: The patients were divided into two groups; pure GGO (n = 50), mixed GGO (n = 65). The pathological tumour size was ≤ 2 cm in 51% of the patients and 27 patients had the size between 2.1 and 3.0 cm. The predominant histopathologic feature was lepidic predominance in 54 patients followed by 24 patients with acinar predominance. Among patients with radiological tumour size of ≤ 2 cm, pure GGO was present in 48% of the patients. Among patients with pure GGO, 96% of the patients had no solid component. 44 patients had only single CT scan before proceeding to surgery. All these patients had mixed GGO. CONCLUSION: Our study concludes pure GGOs, though lacking solid component have a high propensity to be malignant. The role of repeated CT surveillance in this context without offering curative surgery may be questionable.
BACKGROUND: The spectrum of ground glass opacity (GGO) is a diagnostic and clinical management quandary. The role of computed tomographic scans in detecting malignant GGO has inter-observer variability. Pure GGO have been traditionally thought to be predominantly benign in nature and has long volume doubling times. This study was undertaken to correlate the findings of radiology and histology of ground glass opacities at our institute. METHODS: This study is a retrospective observational study of patients who underwent lung resection surgery for radiology proven ground glass opacities between January 2010 and December 2018. A total of 115 patients were included in the study based on inclusion and exclusion criteria and were analysed. RESULTS: The patients were divided into two groups; pure GGO (n = 50), mixed GGO (n = 65). The pathological tumour size was ≤ 2 cm in 51% of the patients and 27 patients had the size between 2.1 and 3.0 cm. The predominant histopathologic feature was lepidic predominance in 54 patients followed by 24 patients with acinar predominance. Among patients with radiological tumour size of ≤ 2 cm, pure GGO was present in 48% of the patients. Among patients with pure GGO, 96% of the patients had no solid component. 44 patients had only single CT scan before proceeding to surgery. All these patients had mixed GGO. CONCLUSION: Our study concludes pure GGOs, though lacking solid component have a high propensity to be malignant. The role of repeated CT surveillance in this context without offering curative surgery may be questionable.
Authors: William D Travis; Elisabeth Brambilla; Masayuki Noguchi; Andrew G Nicholson; Kim R Geisinger; Yasushi Yatabe; David G Beer; Charles A Powell; Gregory J Riely; Paul E Van Schil; Kavita Garg; John H M Austin; Hisao Asamura; Valerie W Rusch; Fred R Hirsch; Giorgio Scagliotti; Tetsuya Mitsudomi; Rudolf M Huber; Yuichi Ishikawa; James Jett; Montserrat Sanchez-Cespedes; Jean-Paul Sculier; Takashi Takahashi; Masahiro Tsuboi; Johan Vansteenkiste; Ignacio Wistuba; Pan-Chyr Yang; Denise Aberle; Christian Brambilla; Douglas Flieder; Wilbur Franklin; Adi Gazdar; Michael Gould; Philip Hasleton; Douglas Henderson; Bruce Johnson; David Johnson; Keith Kerr; Keiko Kuriyama; Jin Soo Lee; Vincent A Miller; Iver Petersen; Victor Roggli; Rafael Rosell; Nagahiro Saijo; Erik Thunnissen; Ming Tsao; David Yankelewitz Journal: J Thorac Oncol Date: 2011-02 Impact factor: 15.609