Small pulmonary lesions detected at CT: Clinical importance

Reginald F. Munden, Robert D. Pugatch, Michael J. Liptay, David J. Sugarbaker, Linh U. Le

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

PURPOSE: To evaluate the histopathologic findings of pulmonary nodules 1 cm or smaller detected at computed tomography (CT) that were removed at video-assisted thorascopic surgery. MATERIALS AND METHODS: Clinical, radiologic, and histopathologic findings were retrospectively reviewed in 64 patients (48 women, 16 men; aged 22-85 years) who underwent video-assisted thorascopic surgical resection of small pulmonary lesions present on CT scans. RESULTS: Sixty-four patients had a total of 65 lesions resected. Of the 64 patients, 37 (58%) patients had no known previous malignancy and 27 (42%) had previous malignancy. Overall, 58% (38 of 65 [95% confidence interval = 0.45, 0.73]) of these lesions were malignant. Among the patients without previous malignancy, 14 (38%) had long carcinoma (10 [27%], primary bronchogenic carcinoma; four [11%], carcinoid). In patients with a previous malignancy, malignant lesions were diagnosed in 81% (22 of 27). This included seven (26%) patients with bronchogenic carcinoma as a second primary carcinoma. In patients without previous malignancy, benign lesions were diagnosed in 59% (22 of 37); in patients with previous malignancy, benign lesions were diagnosed in 18% (five of 27). CONCLUSION: A considerable number of the malignant lesions were primary bronchogenic carcinoma. In addition, diagnosis in patients with a previous malignancy other than suspected metastatic disease can substantially alter treatment. For these reasons, early biopsy with an acceptable technique for diagnosis of these lesions is recommended.

Original languageEnglish (US)
Pages (from-to)105-110
Number of pages6
JournalRadiology
Volume202
Issue number1
DOIs
StatePublished - Jan 1997

Keywords

  • Carcinoid
  • Hamartoma
  • Lung neoplasms
  • Lung neoplasms, diagnosis
  • Lung neoplasms, metastases

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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