Todoroki Keisuke, Kawakami Satoshi, Kiniwa Yukiko, Asaka Shiho, Endoh Hideki, Fujinaga Yasunari
Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Jpn J Radiol. 2025 Jun;43(6):949-957. doi: 10.1007/s11604-025-01745-1. Epub 2025 Feb 5.
To investigate the frequency and characteristics of pulmonary metastases from malignant melanoma presenting as ground-glass opacity nodules (GGNs) on chest computed tomography (CT).
A total of 354 patients with malignant melanoma who underwent chest CT for staging or follow-up were selected. We reviewed the CT images and enrolled 87 patients with lung metastases. Two radiologists evaluated the nodularity of the lung metastases (solid nodules or GGNs). Additionally, the tumor doubling time and disease type (mucosal, cutaneous, or acral melanomas) were analyzed.
GGNs were observed in 13 of 87 (14.9%) patients. The tumor doubling time was 52.0 ± 33.5 days (range: 10.9-111 days) for GGNs and 43.8 ± 27.5 days (range: 9.4-115.3 days) for solid nodules. GGNs changed to solid nodules in 54.5% of patients with increased GGN metastasis. More patients in the GGN group (patients whose metastases included GGNs) had mucosal melanomas than acral melanomas (p = 0.0478); however, no significant difference was observed in the frequency of mucosal and cutaneous melanomas (p = 0.0670). Similarly, the proportion of patients in the GGN-dominant pattern group (patients with GGNs only or more GGNs than solid nodules) who had mucosal melanomas was more than that of patients with acral and cutaneous melanomas (mucosal melanoma vs. acral melanoma, p = 0.0342; mucosal melanoma vs. cutaneous melanoma, p = 0.0344).
Lung metastases from malignant melanoma sometimes appear as GGNs on CT, with a frequency of 14.9% in this study. If lung metastasis is observed as a GGN, the tumor doubling time may be useful for differentiating lung metastasis of malignant melanoma from lung adenocarcinoma.
探讨在胸部计算机断层扫描(CT)上表现为磨玻璃密度结节(GGN)的恶性黑色素瘤肺转移的发生率及特征。
选取354例行胸部CT进行分期或随访的恶性黑色素瘤患者。我们回顾了CT图像,纳入87例肺转移患者。两名放射科医生评估肺转移灶的结节情况(实性结节或GGN)。此外,分析了肿瘤倍增时间及疾病类型(黏膜型、皮肤型或肢端黑色素瘤)。
87例患者中有13例(14.9%)观察到GGN。GGN的肿瘤倍增时间为52.0±33.5天(范围:10.9 - 111天),实性结节为43.8±27.5天(范围:9.4 - 115.3天)。在GGN转移增加的患者中,54.5%的患者GGN转变为实性结节。GGN组(转移灶包括GGN的患者)中黏膜黑色素瘤患者多于肢端黑色素瘤患者(p = 0.0478);然而,黏膜型和皮肤型黑色素瘤的发生率无显著差异(p = 0.0670)。同样地,以GGN为主型组(仅为GGN或GGN多于实性结节的患者)中黏膜黑色素瘤患者的比例高于肢端和皮肤型黑色素瘤患者(黏膜黑色素瘤与肢端黑色素瘤,p = 0.0342;黏膜黑色素瘤与皮肤型黑色素瘤,p = 0.0344)。
恶性黑色素瘤的肺转移在CT上有时表现为GGN,本研究中的发生率为14.9%。如果肺转移表现为GGN,肿瘤倍增时间可能有助于鉴别恶性黑色素瘤肺转移与肺腺癌。