Ultrasmall pulmonary opacities on multidetector-row high-resolution computed tomography: a prospective radiologic-pathologic examination

J Comput Assist Tomogr. 2005 Sep-Oct;29(5):621-5. doi: 10.1097/01.rct.0000172672.09564.8c.

Abstract

Objective: To clarify the pathologic findings of ultrasmall pulmonary opacities (5 mm or smaller in diameter) found on multidetector-row high-resolution computed tomography (MD-HRCT).

Methods: Ten lobes in 10 patients were included in this study. Each lobe had a primary lung tumor and was removed surgically. Two thoracic radiologists noted any tiny nonlinear opacity on preoperative MD-HRCT films (1.25-mm thickness) covering the whole lobe. Pathologic findings of detected opacities were evaluated macroscopically and microscopically.

Results: Among 139 ultrasmall opacities 5 mm or smaller in diameter, 94 corresponded to normal anatomic structures (partial volume averaging or motion artifact), 36 corresponded to pathologic abnormalities, and 9 were unidentified. Histologic diagnoses of 36 pathologic abnormalities were inflammatory lesions (n = 16), intrapulmonary lymph nodes (IPLN; n = 7), atypical adenomatous hyperplasia (AAH; n = 7), bronchioloalveolar carcinoma (BAC; n = 5), and another neoplastic lesion (n = 1).

Conclusion: Tiny pulmonary lesions, such as AAHs, BACs, and IPLNs, were identified among ultrasmall opacities found on MD-HRCT.

MeSH terms

  • Adenocarcinoma, Bronchiolo-Alveolar / diagnostic imaging*
  • Adenocarcinoma, Bronchiolo-Alveolar / pathology
  • Adenomatosis, Pulmonary / diagnostic imaging*
  • Adenomatosis, Pulmonary / pathology
  • Adult
  • Female
  • Humans
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / pathology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Precancerous Conditions / diagnostic imaging*
  • Prospective Studies
  • Tomography, X-Ray Computed / methods*