29. Malignant GGO solitary pulmonary nodule - document review and case reports
Main Article Content
Abstract
A Solitary Pulmonary Nodule (SPN) is a focal opacity on chest radiographs or CT with a clear border; at least partially covered by lung parenchyma; usually spherical; diameter equal to or less than 3 cm; can be solid (Solid Nodule - SN), Non solid (Ground Glass Opacity - GGO) or Semi-solid (Part Solid - PS). One-third of lung cancers present as solitary masses or nodules and the majority are of the adenocarcinoma type. WHO’s updated histopathological classification 2021, Adenocrcinoma is divided into the following types: Minimally Invasive Adenocarcinoma (MIA); Invasive Non-Mucinous Adenocarcinoma (INMA); Invasive Mucinous Adenocarcinoma (IMA); Colloid Adenocarcinoma (CA); Fetal Adenocarcinoma (FA) and Enteric Adenocarcinoma (EA). Minimally invasive adenocarcinoma (MIA) usually has predominant characteristic components, including Lepidic (Lepidic Predominant Adenocarcinoma - LPA) and Acinar Predominant Adenocarcinoma (APA) with varying degrees of low-grade malignancy. We report a case of APA, type GGO, diagnosed and operated at the National Lung Hospital, initially with good results.
Article Details
Keywords
Adenocarcinoma, Acinar predominant adenocarcinoma, Minimally invasive adenocarcinoma, Lung cancer, Lung cancer staging
References
2. Matsunaga T, Suzuki K, Takamochi K, Oh S. What is the radiological definition of part-solid tumour in lung cancer? Eur J Cardiothorac Surg. 2017 Feb 1;51(2):242-247. doi: 10.1093/ejcts/ezw344.PMID: 28119328.
3. Travis WD, Asamura H, Bankier AA, et al.The IASLC lung cancer staging project: Proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2016 Aug;11(8):1204-1223. doi: 10.1016/j.jtho.2016.03.025. Epub 2016 Apr 21.PMID: 27107787.
4. Wu G, Woodruff HC, Shen J, et al. Diagnosis of invasive lung adenocarcinoma based on chest CT radiomic features of part-solid pulmonary nodules: A multicenter study. Radiology. 2020 Nov;297(2):451-458. doi: 10.1148/radiol.2020192431. Epub 2020 Aug 25.PMID: 32840472.
5. Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg. 2020 Dec;110(6):1796-1804. doi: 10.1016/j.athoracsur.2020.04.094. Epub 2020 Jun 7.PMID: 32525031.
6. Mazzone PJ, Lam L. Evaluating the patient with a pulmonary nodule: A review. JAMA. 2022 Jan 18;327(3):264-273. doi: 10.1001/jama.2021.24287.PMID: 35040882.
7. National Comprehensive Cancer Network. 2021. Lung cancer screening. Version 1.2021
8. Chen K, Bai J, Reuben A, et al. Multiomics analysis reveals distinct immunogenomic features of lung cancer with ground-glass opacity. Am J Respir Crit Care Med. 2021 Nov 15;204(10):1180-1192. doi: 10.1164/rccm.202101-0119OC.PMID: 34473939.
9. Liang W, Chen Z, Li C, et al. Accurate diagnosis of pulmonary nodules using a noninvasive DNA methylation test. J Clin Invest. 2021 May 17;131(10):e145973. doi: 10.1172/JCI145973.PMID: 33793424.
10. Fukui M, Takamochi K, Ouchi T, et al. Evaluation of solid portions in non-small cell lung cancer-the solid part is not always measurable for clinical T factor. Jpn J Clin Oncol. 2021 Jan 1;51(1):114-119. doi: 10.1093/jjco/hyaa181.PMID: 33094807.
11. Ko JP, Naidich DP. Current readings: radiologic interpretation of the part - solid nodule: clinical relevance and novel technologies. Semin Thorac Cardiovasc Surg. 2014 Summer;26(2):145-56. doi: 10.1053/j.semtcvs.2014.07.001. Epub 2014 Jul 16. PMID: 25441005.
12. Kamiya S, Iwano S, Umakoshi H, et al. Computer-aided volumetry of part-solid lung cancers by using CT: Solid component size predicts prognosis. Radiology. 2018 Jun;287(3):1030-1040. doi: 10.1148/radiol.2018172319. Epub 2018 Mar 14.PMID: 29533722.
13. Ye T, Deng L, Wang S, et al. Lung adenocarcinomas manifesting as radiological part-solid nodules define a special clinical subtype. J Thorac Oncol. 2019 Apr;14(4):617-627. doi: 10.1016/j.j tho.2018.12.030. Epub 2019 Jan 17. PMID: 30659988.
14. Chae M, Jeon JH, Chung JH, et al. Prognostic significance of tumor spread through air spaces in patients with stage IA part-solid lung adenocarcinoma after sublobar resection. Lung Cancer. 2021 Feb;152:21-26. doi: 10.1016/j.lungcan.2020.12.001. Epub 2020 Dec 5.PMID: 33338924.