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纯磨玻璃样肺结节的评估:一例报告

Evaluation of pure ground glass pulmonary nodule: a case report.

作者信息

Jin Ning, Sloane Peter J

机构信息

Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.

出版信息

J Community Hosp Intern Med Perspect. 2014 Sep 29;4(4). doi: 10.3402/jchimp.v4.24562. eCollection 2014.

Abstract

A pulmonary nodule is a single, nearly spherical, well-circumscribed pulmonary opacity up to 30 mm in diameter and surrounded by aerated lung tissue. In radiographs, pulmonary nodules may appear as solid, completely obscuring the lung parenchyma, or as subsolid, not completely obscuring adjacent tissues. A subsolid pulmonary nodule may be further subclassified as a pure ground glass nodule (pGGN) or a part solid nodule, a mixture of ground glass components and focal opacity obscuring the adjacent tissues. Guidelines for evaluation of solid pulmonary nodules are based on nodule size, recommending vigilance and non-operative management for small nodules (less than 8 mm in diameter) and diagnostic biopsy for nodules with a diameter of 8 mm or more. However, subsolid ground glass pulmonary nodules are an exception to this rule. Although small in size, persistent subsolid nodules are potentially premalignant or malignant. We present the case of a non-smoker who was found to have an incidental pulmonary pGGN. We then discuss the radiologic appearance, histology, clinical outcomes, and evaluation and management strategy of subsolid pulmonary nodules compared with solid nodules.

摘要

肺结节是单个、近乎球形、边界清晰的肺部不透光区,直径达30毫米,周围为含气肺组织。在X线片上,肺结节可能表现为实性,完全遮挡肺实质,或为亚实性,不完全遮挡相邻组织。亚实性肺结节可进一步细分为纯磨玻璃结节(pGGN)或部分实性结节,即磨玻璃成分与遮挡相邻组织的局灶性不透光区的混合。实性肺结节的评估指南基于结节大小,对于小结节(直径小于8毫米)建议密切观察和非手术治疗,对于直径8毫米或更大的结节则建议进行诊断性活检。然而,亚实性磨玻璃肺结节是这条规则的例外。尽管尺寸较小,但持续存在的亚实性结节可能是癌前病变或恶性病变。我们报告一例偶然发现肺pGGN的不吸烟者病例。然后我们将讨论亚实性肺结节与实性结节相比的影像学表现、组织学、临床结果以及评估和管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a991/4185143/c6c7dacac839/JCHIMP-4-24562-g001.jpg

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