J Korean Soc Radiol.  2013 Feb;68(2):99-106. 10.3348/jksr.2013.68.2.99.

CT Findings of Solitary Pulmonary Nodules Less than 8 mm to Differentiate the Malignant and Benign

• Yoon KW
• Jin GY
• Han YM
• Kim EY

• KMID: 2097987
• DOI: http://doi.org/10.3348/jksr.2013.68.2.99

Abstract

PURPOSE
We assessed CT features of the solitary pulmonary nodules (SPNs) smaller than 8 mm to evaluate the differences between the benign and malignant nodules.
MATERIALS AND METHODS
The study included 113 patients (66 male, 47 female, age range: 33-79 years) with SPNs smaller than 8 mm. Mean diameter of SPN on CT was 4.95 +/- 1.19 cm; benign, 4.91 +/- 1.24 mm; and malignant, 6.09 +/- 1.01 mm. Of the 113 nodules, there were 23 (20.4%) malignant nodules and 90 (79.6%) benign nodules. The CT findings (size, shape, margin, density) of SPNs were analyzed. The statistical differences of the malignant and benign nodules were analyzed by chi2 test.
RESULTS
The differences of the benign and malignant nodules were in the margin and density. In the margins, spiculation and lobulation occurred with a significantly higher frequency in the malignant nodules (spiculated: 10/23, lobulated: 7/23) than the benign nodules (spiculated: 20/90, lobulated: 0/90) (p < 0.001). In the mixed or pure ground glass attenuation (14/23), the malignancy rates were significantly higher than the solid nodules (p < 0.001). In the mixed and pure attenuation, a lobulated or spiculated margin (12/14) was associated with a higher risk of malignancy (p = 0.005).
CONCLUSION
In smaller than 8 mm nodules, the predictive CT findings of malignancy were spiculated or lobulated margin and mixed or pure attenuation.

MeSH Terms

Female
Glass
Humans
Lung Neoplasms
Male
Multidetector Computed Tomography
Solitary Pulmonary Nodule

Figure

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  Fig. 1 Bronchioloalveolar cell carcinoma in a 39-year-old man. Non-contrast CT with lung setting shows a 7 mm sized subsolid nodule with the spiculated mixed ground-glass attenuation in the right lower lobe.

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  Fig. 2 Bronchioloalveolar cell carcinoma in a 37-year-old woman. Non-contrast CT with lung setting shows a 7 mm sized pure ground-glass attenuation nodule with lobulated margin.

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  Fig. 3 Anthracotic pigmentation in a 69-year-old man. Non-contrast CT with lung setting shows a 4.5 mm sized solid nodule with smooth margin.

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  Fig. 4 Adenocarcinoma in situ, non-mucinous type in a 50-year-old man. Non-contrast CT with lung setting shows a 5 mm sized pure ground-glass attenuation nodule with lobulated margin.

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