title: Persistent pure ground-glass opacity lung nodules ≥ 10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications.
abstract: BACKGROUND
  Little is known about the histopathology and prognosis of persistent pure ground-glass opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis.
  
  
  METHODS
  A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated.
  
  
  RESULTS
  The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram (P = .012), size of nodule (P = .032, cutoff = 16.4 mm in diameter), and mass of nodule (P = .040, cutoff = 0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size (P = .010) and mass of nodule (P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection.
  
  
  CONCLUSIONS
  In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lim
authors.affiliation: Department of Pathology, Seoul, South Korea.
authors.forename: Soomin
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea. Electronic address: kyungs.lee@samsung.com.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Pathology, Seoul, South Korea.
authors.forename: Joungho
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, Seoul, South Korea.
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
authors.affiliation: Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Sookyoung
authors.initials: S
authors.lastname: Woo
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea.
authors.forename: Jae-Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea.
authors.forename: Miyeon
authors.initials: M
authors.lastname: Yie
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea.
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Radiology and Center for Imaging Science, Seoul, South Korea.
authors.forename: Chin A
authors.initials: CA
authors.lastname: Yi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed