Mucin-producing adenocarcinoma of the lung: thin-section computed tomography findings in 48 patients and their effect on prognosis.
OBJECTIVE
To determine the prognostic value of thin-section computed tomography (CT) findings in patients with mucin-producing adenocarcinoma (MPA) of the lung.


METHODS
The study included 48 patients with pathologically proven MPA who had thin-section CT before treatment. The CT findings were correlated with the histopathologic findings and with disease-free survival on follow-up in all patients.


RESULTS
Computed tomography findings identified in patients with MPA of the lung included an air bronchogram (n = 37, 77.1%), areas of ground-glass attenuation (n = 36, 75.0%), areas of air-space consolidation (n = 36, 75.0%), interlobular septal thickening (n = 33, 68.8%), bubble-like lucencies (n = 23, 47.9%), centrilobular nodules (n = 22, 45.8%), and mucus filling of airways (n = 19, 39.6%). Twenty-two (45.8%) of the 48 patients had intrapulmonary metastases. Centrilobular nodules (odds ratio [OR] = 6.7, 95% confidence interval: 1.1-41.4; P < 0.05) and mucus filling of airways (OR = 14.4, 95% 95% confidence interval: 2.0-102.7; P < 0.01) on thin-section CT were independently associated with an increased likelihood of intrapulmonary metastases. The 5-year disease-free survival rates were 67.9% and 38.4% for patients without and with intrapulmonary metastases, respectively (P < 0.05). The presence of centrilobular nodules (relative risk = 10.5, 95% confidence interval: 1.8-59.3; P < 0.01) on thin-section CT was an independent predictor of poor prognosis.


CONCLUSIONS
Centrilobular nodules on CT are associated with a higher prevalence of intrapulmonary metastases and a poor prognosis in patients with MPA of the lung.
Tateishi
Ukihide
U
Division of Diagnostic Radiology, National Cancer Center Hospital and Institute, Tokyo, Japan. utateish@ncc.go.jp
Müller
Nestor L
NL
Johkoh
Takeshi
T
Maeshima
Arafumi
A
Asamura
Hisao
H
Satake
Mitsuo
M
Kusumoto
Masahiko
M
Arai
Yasuaki
Y
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000096:biosynthesis*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D009077:Mucins