title: A clinicopathological study of resected pulmonary nodules with focal pure ground-glass opacity.
abstract: OBJECTIVE
  Pulmonary lesions with focal ground-glass opacity (GGO) have been detected increasingly by low-dose helical computed tomography (CT). However, the strategy of treatment for focal pure GGO lesions is still undecided. This study evaluates clinicopathological characteristics of resected pulmonary nodules with focal pure ground-glass opacity.
  
  
  METHODS
  Between January 1997 and December 2005, 26 patients (35 lesions) with pure GGO lesions underwent pulmonary resection. The data on patient age, lesion size, pathology, carcinoembryonic antigen (CEA) level and palpability of the tumor in the resected specimen were evaluated.
  
  
  RESULTS
  The histological diagnosis was bronchioloalveolar carcinoma (BAC) in 10 patients (12 lesions), atypical adenomatous hyperplasia (AAH) in 15 patients (22 lesions), and focal scar in 1 patient (1 lesion). There were no significant differences in age, sex, tumor size, and CEA level between the patients with BAC, AAH, and focal scar. However, the lesions >10mm in size were all BAC. Palpability of the tumor in the resected specimen was significantly more frequent in BAC cases than in AAH cases (p<0.01). For BAC, lobectomy was performed for four lesions, and limited resection for eight. None of the BACs showed lymphatic or vascular invasion upon pathological examination. At the median follow-up point of 44 months (range: 4-84 months), no recurrences were observed.
  
  
  CONCLUSIONS
  BAC and AAH cannot be discriminated by their size. In the resected specimen, BAC lesions are more frequently palpable than AAH lesions. Thoracoscopic surgery is recommended for focal pure GGO after repeated CT even if the GGO lesion is small. Partial resection is a sufficient treatment for pure GGO.
authors.affiliation: Department of Thoracic Surgery, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan. t-oh@remus.dti.ne.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kaji
authors.forename: Tsuguo
authors.initials: T
authors.lastname: Naruke
authors.forename: Keiichi
authors.initials: K
authors.lastname: Suemasu
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018255:Adenomatosis, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010173:Palpation; D014057:Tomography, X-Ray Computed
chemical_list: D002272:Carcinoembryonic Antigen