J Korean Soc Radiol.  2018 May;78(5):309-320. 10.3348/jksr.2018.78.5.309.

Pulmonary Subsolid Nodules: An Overview & Management Guidelines

• Song YS
• Park CM

• KMID: 2410720
• DOI: http://doi.org/10.3348/jksr.2018.78.5.309

Abstract

Pulmonary subsolid nodules (SSNs) refer to the pulmonary pure ground-glass nodules and part-solid nodules. SSNs are frequently encountered in clinical settings, such as in screenings conducted with chest computed tomography. The main concern regarding pulmonary SSNs, particularly when they are persistent, has been a lung adenocarcinoma and the precursors to this condition. This review aims at describing the current understanding of the imaging features, histology, natural course, and to present the current management protocols based on the guidelines recently established by the Fleischner Society.

MeSH Terms

Adenocarcinoma
Carcinoma, Non-Small-Cell Lung
Lung
Lung Neoplasms
Mass Screening
Multiple Pulmonary Nodules
Solitary Pulmonary Nodule
Thorax

Figure

• 

  Fig. 1. Representative CT images of subsolid nodules. A. An 1-mm-thick section axial image of the left upper lobe shows a pure ground-glass nodule. There is a focal nodular area of increased lung attenuation through which the pulmonary vessels can be observed. B. An 1-mm-thick section axial image of the right upper lobe shows a part-solid nodule. This nodule presents with both ground-glass and solid components in which the underlying lung architecture cannot be visualized.

• 

  Fig. 2. A transient subsolid nodule in a 43-year-old man. A. An initial 1-mm-thick section CT image shows a part-solid nodule in the left upper lobe. B. A follow-up 1-mm-thick section CT image acquired 1 month later shows resolution of the nodule, consistent with an infectious or inflammatory process.

• 

  Fig. 3. A pure ground glass nodule with a bubble lucencies in a 65-year-old man. A. An 1-mm-thick section image of the lung window setting showed a 1.5 cm pure ground-glass nodule in the right upper lobe. B. The nodule had increased in size (to 2.0 cm) at the final follow-up 18 months after the initial CT. The nodule proved to be invasive adenocarcinoma.

• 

  Fig. 4. Progression of a subsolid nodule during follow-up. Consecutive 1-mm-thick sections through left upper lobe section obtained at same anatomic level over a 3-year period (A: baseline, B: 3 years) show transformation of initial pure ground-glass nodule to a part-solid nodule, which subsequently proved to be adenocarcinoma in situ.

Reference

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