Small pulmonary nodules on CT accompanying surgically resectable lung cancer: likelihood of malignancy.
The aim of this study was to determine the likelihood of malignancy in small nodules in the nonprimary lobe in patients with resectable bronchogenic carcinoma. In 141 patients who underwent curative resection of bronchogenic carcinoma and had adequate follow-up CT examinations, the presence of small nodules in the nonprimary lobe preoperatively and change of preexisting nodules, if any, was assessed. The criteria used to determine benignity of a nodule was stability or decrease in size for 24 months on CT. Histopathology of the nodules was reviewed for an additional 10 patients who underwent surgical biopsy for an accompanying nodule before curative surgery. Sixty-two (44%) of 141 patients had a total of 138 small (< or = 10 mm) nodules in the nonprimary lobes (< 5 mm in 113, 5-10 mm in 25). Of these 138 nodules, 132 were benign with only six nodules malignant (with histopathologic confirmation for the enlarging nodules). The 132 benign nodules showed no change (n = 120), decrease in size (n = 11), or increase in size (n = 1) on follow-up studies, with the single enlarging nodule proved benign on biopsy. In 10 patients who had a preoperative biopsy of a single preexisting nodule in the nonprimary lobe (< 5 mm = 1; 5-10 mm = 5; > 10 mm = 4) two proved to be malignant (both > 10 mm) and eight were benign. Most small (< 10 mm) nodules associated with resectable bronchogenic carcinoma are benign, consistent with published results of other studies. However, a small number of nodules are malignant and CT does not reliably distinguish between benign and malignant nodules.
Kim
Young Han
YH
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Lee
Kyung Soo
KS
Primack
Steven L
SL
Kim
Hojoong
H
Kwon
O Jung
OJ
Kim
Tae Sung
TS
Kim
Eun A
EA
Kim
Jhingook
J
Shim
Young Mog
YM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed