Management of multiple pure ground-glass opacity lesions in patients with bronchioloalveolar carcinoma.
BACKGROUND
The objective of this study was to evaluate the clinical characteristics and long-term outcome of multiple pure ground-glass opacity (GGO) lesions detected in patients undergoing pulmonary resection for bronchioloalveolar carcinoma (BAC).


METHODS
Between January 2000 and December 2007, 73 patients underwent pulmonary resection for BAC. Of those, 23 patients had multiple pure GGOs on their preoperative computed tomography (CT) scans. Eighty-nine GGO lesions were detected with a median number of 3 (range, 2-11) per patient. Resection included wedge resection in 12 patients, lobectomy in 7, lobectomy with wedge resection in 3, and bilobectomy in 1. Five patients had all GGOs lesions resected (group I), whereas 18 had some of the GGO lesions resected and the remaining lesions followed by serial CT scans (group II). Median follow-up was 40.3 months.


RESULTS
No late death occurred during the follow-up period. In group I, four patients had no recurrences and one patient developed a new lesion that was resected and found to be adenocarcinoma. In group II, GGO lesions either did not change in size (n = 15) or disappeared (n = 3) in all patients. No GGO lesions increased in size or developed a solid component during the follow-up period.


CONCLUSIONS
When multiple pure GGO lesions in patients with BAC remained without surgical resection, there was no change in their size or features during follow-up. When it is not feasible to resect all GGO lesions in patients with multifocal BAC, close follow-up using CT scans represents an alternative to surgical resection.
Kim
Hong Kwan
HK
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
Yong Soo
YS
Kim
Jhingook
J
Shim
Young Mog
YM
Lee
Kyung Soo
KS
Kim
Kwhanmien
K
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome