title: Small pulmonary nodules on CT accompanying surgically resectable lung cancer: likelihood of malignancy.
abstract: 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.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Han
authors.initials: YH
authors.lastname: Kim
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Steven L
authors.initials: SL
authors.lastname: Primack
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Kim
authors.forename: Eun A
authors.initials: EA
authors.lastname: Kim
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
mesh_terms: 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