Lung VCAR Clinical Case 2

Male aged 32 who underwent CT scan of the thorax on account of lower chest pains. A nodule of non-solid density was detected and, in view of the very low prevalence of bronchopulmonary cancer in the under 35 population, kept under observation. Despite the stability of this nodule over 4 years, it was decided to operate on account of the non-solid density of the nodule (-301 HU) and its size (almost one centimetre).

Possible etiologies were non-tumoral (a focus of desquamative interstitial pneumonitis or pulmonary fibrosis), benign tumoral (atypical adenomatous hyperplasia, considered as a premalignant dysplasia, generally smaller than 5 mm) or malignant tumoral (bronchiolo-alveolar carcinoma or adenocarcinoma). The final diagnosis was primary pulmonary adenocarcinoma.


Lung VCAR Clinical Case

This case illustrates that for “ground glass” nodules change over time represents only one of the criteria for judgement, and one which has much less value than in the case of a solid nodule. Average volume-doubling times of 813 days have thus been reported for “ground glass” tumoral nodules.


Lung VCAR Clinical Case

Assessment of density, and in particular the search for a tissue component and its quantification, appear much more relevant in the follow-up of this type of nodule, which is encountered with increasing frequency.