Natural progression of lung ground glass opacity (GGO) to lung cancer over 7 years

Case contributed by Dr Chris O'Donnell

Presentation

Incidental finding on a chest radiograph in 2008. Now cough for 3 weeks. Smoker.

Patient Data

Age: 75
Gender: Female

CT Chest (two different exams in a 7-year period)

Modality: CT

Small ground glass opacity in the left apical segment of lower lobe. Note no distortion of vessels or solid component. Progression in 7 years to a solid, spiculated mass with extension to the pleura and central cavitation.

No FDG accumulation in the left apical segment of lower lobe thus thought to be a benign lesion

Case Discussion

Detection of ground glass opacities is an important component of lung cancer screening. These lesions are thought to be premalignant ie atypical adenomatous hyperplasia progressing to minimally invasive adenocarcinoma and then invasive malignancy. They can be very slow growing (ie 7 years in this case) and are usually non FDG avid. Determination of when to biopsy and/or excise is problematic. Growth or development of a solid (nodular) component are critical concerning findings.  CT follow-up should be for at least 3 years.

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Case Information

rID: 39347
Case created: 1st Sep 2015
Last edited: 3rd Sep 2015
System: Chest
Inclusion in quiz mode: Included

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