A clinicopathological study of resected XXXX : a favorable prognosis for ground glass opacity lesions.

@entity1 @entity4153 @entity5 @entity75 @entity957 @entity2 @entity133 @entity3 @entity420
BACKGROUND: Owing to the advent of refined chest computed tomography (CT) images with higher resolution and CT screening programs, more faint and @entity2 are being discovered. These include small-sized @entity2 such as those with a subcentimeter diameter, which had never been picked up on the routine chest roentgenogram films. However their clinicopathological characteristics with special reference to the proper surgical mode are not fully described so far. METHODS: During a 10-year period from 1991 through 2000 a total of 1,769 @entity2 were resected at the National @entity5 Center Hospital, Tokyo. According to the pathology files of these @entity1 , 51 @entity1 had a @entity5 with the diameter of 1 cm or less. Three @entity5 arising in the bronchial lumina of hilum with a @entity957 histology were excluded and the remaining 48 @entity5 of peripheral origin were studied. The clinicopathological features were analyzed according to three types of appearance on high-resolution CT: non-solid ground glass opacity (GGO) type (n = 19); part-solid GGO type (n = 9); and solid type (n = 20). Non-solid GGO is made up of homogeneous moderate increased density on CT, which cannot obscure the bronchovascular structure, whereas partly solid GGO contains a mere solid part but did not exceed 50% of the whole area (n = 9). All other lesions were considered solid type. RESULTS: For the three types of lesions, the distribution of age and sex was similar with the average age of 61 years and an almost even distribution of male/female @entity1 . Although 6 @entity1 had symptoms, the symptoms were not associated with the nodule itself. Twenty-six @entity1 (54%) were screen-detected (16 chest roentgenogram films and 10 CT scans) and the others were detected by incidentally taken chest roentgenogram film or CT for other reasons than nodules detected. Two @entity957 were positive for sputum cytology. Preoperative cytologic/histologic diagnosis was given in 14 @entity1 (29%). The histologic type of GGO lesion was @entity133 in all 28 cases. In solid lesions, besides 16 @entity420 2 cases of @entity957 , 1 case each of @entity4153 and @entity5 was seen. Lymph node involvement was seen only in 3 @entity1 with solid lesions (N1 in 2 @entity1 , N2 in 1 @entity1 ). As for operative mode, the limited resection was performed for 15 @entity75 (54%) and 4 solid lesions (20%). @entity5 recurrence was seen in 2 @entity1 with solid lesions-1 in bone and the other in locoregional lymph node, and the former died of disease. CONCLUSIONS: Among @entity2 , @entity75 (both non-solid and part-solid) constitute @entity2 . Since they have minimal or no invasive growth, limited resection for cure is justified. Conversely the solid lesion had significant invasive features such as lymph node @entity3 . Lobectomy should remain as the standard mode of surgery despite such small size.
