CT characteristics of resolving ground-glass opacities in a lung cancer screening programme.

PURPOSE: This study aimed at evaluating the computed tomography (CT) characteristics of resolving localized ground-glass opacities (GGOs) in a screening programme for lung cancer. MATERIAL AND METHODS: 280 patients at high-risk for lung cancer (221 men, 59 women; mean age, 58.6 years), divided into four groups (lung cancer history (n = 83), head and neck cancer history (n = 63), symptomatic (n = 88) and asymptomatic (n = 46) cigarette smokers), were included in a prospective trial with annual low-dose CT for lung cancer screening. We retrospectively reviewed all localized GGOs, analyzed the CT characteristics on initial CT scans and changes during follow-up (median 29.1 months). Variables associated with resolution of GGOs were tested using chi-square or Mann-Whitney tests. RESULTS: A total of 75 GGOs were detected in 37 patients; 54.7% were present at baseline and 45.3% appeared on annual CT. During follow-up, 56.2% persisted and 43.8% disappeared. The resolving localized GGOs were significantly more often lobular GGOs (p = 0.006), polygonal in shape (p = 0.02), mixed (p = 0.003) and larger (p < 0.0001) than non-resolving localized GGOs. CONCLUSION: Localized GGOs are frequent and many disappeared on follow-up. CT characteristics of resolving GGOs show significant differences compared to persistent ones. This study emphasizes the importance of short-term CT follow-up in subjects with localized GGOs.

CT Features of an unusual calcified schwannoma of the superior laryngeal nerve.

We report the CT findings in a patient with a lateral neck mass histologically diagnosed as a laryngeal schwannoma but presenting some uncommon CT features. CT showed unusual calcified components, very rarely observed and potentially misleading for diagnosis. However, this imaging feature can be found in ancient schwannomas. Our case is, therefore, a very rare one and reviews the main differential diagnoses.

[Non-solid and part-solid pulmonary nodules on CT scanning]. / Nodules pulmonaires partiellement ou totalement en verre dépoli.

INTRODUCTION: The entities of non-solid and part-solid pulmonary nodules on CT scan have been recently described. STATE OF ART: Nonsolid and part-solid pulmonary nodules account for between 2.9 and 19% of all pulmonary nodules detected in high-risk patients included in CT screening series for lung cancer. Radio-pathological correlations have shown that the aetiology could be either benign (chronic pneumonia, atypical adenomatous hyperplasia, localized fibrosis) or malignant (broncholoalveolar cell carcinoma, adenocarcinoma, more rarely metastasis). Part-solid or non-solid nodules are more likely to be malignant than solid ones. The doubling time of non-solid nodules can be longer than part-solid ones and even longer than the doubling time of solid nodules. Patient prognosis is related to the proportion of the ground glass component. PERSPECTIVE: The management of these nodules requires prolonged surveillance of nodules less than 10mm in diameter and surgical excision of nodules greater than 10mm persisting on scans between 1 to 3 months after they have been discovered and anti-inflammatory and anti-infectious therapy has been administered. CONCLUSIONS: Nonsolid and part-solid pulmonary nodules found on CT scan warrant a specific diagnostic workup.