title: Ground-glass attenuation in nodular bronchioloalveolar carcinoma: CT patterns and prognostic value.
abstract: OBJECTIVE
  The purpose of our study was to assess the CT patterns and prognostic value of ground-glass attenuation in nodular bronchioloalveolar carcinoma (BAC).
  
  
  METHODS
  We retrospectively reviewed CT examinations of 22 patients with 24 nodular BACs who underwent surgery. CT and pathologic findings were analyzed and correlated with postoperative course of disease.
  
  
  RESULTS
  We detected five patterns of ground-glass attenuation associated with nodular BAC: pure ground-glass nodule (n = 1), ground-glass nodule with superimposed lymphangitis (n = 1), nodule with mixed areas of ground-glass attenuation and consolidation (n = 2), ground-glass halo around nodule (halo sign) (n = 3), and nodule associated with a plurisegmental area of ground-glass attenuation (n = 1). Two patients with the halo sign and a third patient with a plurisegmental area of ground-glass attenuation rapidly developed diffuse pulmonary disease by bronchogenic spread and died a few months after surgery.
  
  
  CONCLUSIONS
  Our series demonstrates that focal BAC may progress to diffuse pulmonary involvement by bronchogenic spread. The presence of a large area of ground-glass attenuation associated with a nodular BAC might be the CT sign of an aggressive biologic behavior. In these cases there is a high likelihood for diffuse disease to develop from bronchogenic spread.
authors.affiliation: Service of Diagnostic Imaging, Ospedale Piemonte, Messina, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gaeta
authors.forename: R
authors.initials: R
authors.lastname: Caruso
authors.forename: M
authors.initials: M
authors.lastname: Barone
authors.forename: S
authors.initials: S
authors.lastname: Volta
authors.forename: G
authors.initials: G
authors.lastname: Casablanca
authors.forename: F
authors.initials: F
authors.lastname: La Spada
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed