[28] Prospective studies are required to further validate the association between GGO nodules and the presence of driver mutations. It is important to keep in mind that “GGO” is a rather unspecific radiologic feature seen in a number of clinical conditions involving different pathologic processes. 31. The sizes of solid attenuation and ground glass opacity were evaluated radiologically and the relationships between radiologic findings and clini-copathologic features were investigated to define periph-eral early lung cancer. 2015;25:185-97. http://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf. [46] Most GGO nodules thus have an indolent clinical course[47]; this is especially true in screening settings, where the participants are without symptoms. 2019 Jun;98(25):e16119. Jpn J Clin Oncol. Eur Respir J. Background: The introduction of HRCT scan for screening has enabled the earlier detection of lung cancer. Most of the evidence regarding markers is derived from studies of peripherally located solid nodules smaller than 15 mm. Types of benign lung tumors include hamartomas, adenomas and papillomas. ; Cigarette smoking is the principal risk factor for development of lung cancer. MIA is a small (3 cm or less) solitary adenocarcinoma with a predominantly lepidic pattern and invasion of 5 mm or less at the largest dimension. Growth in linear measures. 2008;3:340-7. 2015;33:3439-46. The IASLC Lung Cancer Staging Project: Proposals for Coding T Categories for Subsolid Nodules and … 2011;258:243-53. For example, if a biopsy shows a lepidic pattern and CT shows a pure GGO nodule, this would favor a diagnosis of AIS, or possibly MIA, and would make a diagnosis of lepidic-predominant adenocarcinoma less likely, while if a mostly GGO nodule also had a solid component measuring more than 5 mm, this would favor a diagnosis of lepidic-predominant adenocarcinoma. Gonfiotti A, Davini E, Vaggelli L, et al. Subtype classification of lung adenocarcinoma predicts benefit from adjuvant chemotherapy in patients undergoing complete resection. 10. MacMahon H, Austin JH, Gamsu G, et al. McConnell PI, Feola GP, Meyers RI. 2014;14:312. Types of benign lung tumors include hamartomas, adenomas and papillomas. Smoker. Application of deep learning (3-dimensional convolutional neural network) for the prediction of pathological invasiveness in lung adenocarcinoma: A preliminary study. In malignant part-solid GGO nodules, the solid part histologically represents invasion, whereas the pure GGO areas are considered adenocarcinoma in situ (AIS). They appear as round, white shadows on a chest X-ray or computerized tomography (CT) scan. Oncol Rep. 2011;26:1205-11. Soh J, Toyooka S, Ichihara S, et al. Diameter of tumors showing PGGO was 9.3+/-mm (mean +/- S.D. 2002 Feb;73(2):386-92; discussion 392-3. doi: 10.1016/s0003-4975(01)03410-5. Sequential molecular changes during multistage pathogenesis of small peripheral adenocarcinomas of the lung. Chang B, Hwang JH, Choi YH, et al. Would you like email updates of new search results? [33] The FS guidelines recommend annual surveillance CT scans for a minimum of 3 years. I had ... 547 Replies The purpose of this manuscript is to review best available evidence papers on management of GGO in lung cancer … [35,36] Thus, the BTS guidelines recommend that GGO nodules be followed for at least 4 years. J Thorac Cardiovasc Surg. Following the results of the National Lung Screening Trial (NLST) in the United States,[1] LDCT screening for lung cancer is being implemented in the United States and China[2,3] and is under consideration in many other countries. In: Baert AL, Knauth M, Sartor K, editors. The radiologist said he suspects interstitial fibrosis and obstructive Lung disease. We performed a literature search of the PubMed/MEDLINE database to identify articles reporting GGO. Ann Thorac Surg. Epub 2019 Nov 6. McWilliams A, Tammemagi MC, Mayo JR, et al. A nonrandomized confirmatory phase III study of sublobar surgical resection for peripheral ground glass opacity dominant lung cancer defined with thoracic thin-section computed tomography (JCOG0804/WJOG4507L). [25] Finally, in a recent study, GGO nodules negative for four driver mutations (EGFR, KRAS, ALK, and HER2) were associated with no growth, whereas EGFR mutation–positive GGO nodules demonstrated a correlation with growth. Lung nodules are very common, especially in people who have smoked, but not all lung nodules mean lung cancer; there are many possible causes. For nodules 15 mm or smaller, growth is defined as an increase in the mean diameter of 2 mm or more in any nodule or in the solid portion of a part-solid nodule when compared with the baseline scan. [36], Suspicious GGO nodules may have to be surgically removed via video-assisted thoracoscopic surgery (VATS) for diagnostic or therapeutic reasons. The impact of histology and ground-glass opacity component on volume doubling time in primary lung cancer. Yanagawa M, Niioka H, Hata A, Kikuchi N, Honda O, Kurakami H, Morii E, Noguchi M, Watanabe Y, Miyake J, Tomiyama N. Medicine (Baltimore). Tsutani Y, Miyata Y, Nakayama H, et al. [55] In recent years, improvements in CT scanning resolution, combined with increased use of CT screening, has led to the increased detection of GGO lesions that represent noninvasive or MIA types of lung cancer with a favorable prognosis. [53] Centrally located GGO lesions are more difficult to resect and may in rare cases require a diagnostic lobectomy, even though this should be the diagnostic approach of last resort.[54]. This review focuses on the radiologic and pathologic features of ground-glass opacity nodules, along with the clinical management of these lesions. A plethora of clinical conditions may manifest as transient GGOs that will resolve with the treatment of the underlying disorder. Medical radiology, diagnostic imaging. Zhao SJ, Wu N. Early detection of lung cancer: low-dose computed tomography screening in China. We retrospectively reviewed the effect of stereotactic body radiation therapy (SBRT) in patients with stage I lung cancer whose lung tumor showed a nodular appearance of ground glass opacity, so-called ground glass nodule (GGN). Follow - 1. doi: 10.21037/jtd.2018.01.172. 2013;146:24-30. [8] GGO nodules are often slow-growing, and if malignant transformation from carcinoma in situ does occur, the process may take years-which is why longer follow-up time is necessary (see section on management). 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