J Korean Radiol Soc.
1995 Jan;32(1):85-91.
CT Evaluation of Solitary Pulmonary Nodule
Abstract
- PURPOSE
To evaluate criteria for differentiating benign versus malignant solitary pulmonary nodules (SPNs)
by analyzing their morphology and perinodular parenchymal changes on CT/HRCT.
MATERIALS AND METHODS
We retrospectively reviewed the CT/HRCT in 99 patients with SPN. Sixty two
cases were proved by surgery, PCNA, clinical follow up and etc. Thirty seven cases were diagnosed by typical
benign calcification. We defined SPN as a discrete, single lesion in the lung with margins that are sharp enough
to permit measurement of diameter. We excluded lesions more than 4cm in diameter and lesions with cavity
from our study protocol. The study included 41 malignant nodules and 58 benign nodules.
RESULTS
Mean diameter of malignant nodule was 2.9cm, benign nodule was 2.2cm. Peripheral location of
nodule was 28 in malignant nodules, 50 in benign nodules. Typical benign calcification was observed in 37
tuberculoma and three hamartoma. Lobulated margin was noted in 32 malignant nodules and 14 benign
nodules. Spiculated margin was observed in 17 malignant nodules and 20 benign nodules. Low attenuation
within the nodule was observed in 14 malignant nodules and 12 benign nodules. Pleural tail was observed in 14
malignant nodules and 31 benign nodules. Air bronchogram was noted in 18 malignant nodules and 4 benign
nodules. Juxta nodular tuberculosis was observed in 6 malignant nodules and 29 benign nodules.
CONCLUSION
Malignant nodules were larger than benign nodules and more commonly demonstrated a
Iobulated contour and air bronchogram (p<0.05). Benign nodules more commonly demonstrated low density in
the nodule and associated with juxta nodular tuberculosis and peripheral location (p<0.05). Spiculated margin
and pleural tail were not helpful to differentiate benign from malignant nodule.