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Vol.42 No.7 contents | Japanese/English |
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CT Diagnosis of Lung Cancer: The Detection and Differentiation of Small Pulmonary Nodules
Tsuneo Matsumoto11Department of Radiology, Yamaguchi University School of Medicine, Japan.
We presented typical and atypical CT findings of small lung cancers and benign lesions. Endobronchial lung cancers and located centrally may be missed on CT, as well as small lung cancers near the threshold for the detectability. A potential contributor to overlooked lung cancer is a satisfaction-of-search error. Well-defined and smooth edges are typical of benign lesions. Although some malignant nodules such as endobronchial tumors show well-defined and slightly lobulated edges, benign patterns of calcification, presence of fat, absence of significant lung nodule enhancement and no connection between vessels and the nodule at CT are strongly predictive of a benign nature. Most nodules with irregular or spiculated edges are malignant. However, some benign nodules such as organizing pneumonia show these edges, and the presence of satellite lesions, thickening of bronchovascular bundles and a concave contour are suggestive of a benign nature. Well-defined margins and notches are suggestive of a malignant lesion in nodules with only ground-glass attenuation. Note that some lung cancers in emphysema patients show findings similar to focal organizing pneumonia, i.e. a spindle-shaped or trapezoidal lesion adjacent to the pleura or along the bronchovascular bundle and evidence of satellite lesions. The CT findings around the nodules and in the whole lung field and the clinical information of present illness or past history are sometimes important in the differentiation of small pulmonary nodules.
key words: HRCT, Observer error, Replacement of alveolar lining cell, Nodule, Ground-glass attenuation
JJLC 42 (7): 686-697, 2002
