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- Original Article -

Useful Radiological Features for the Diagnosis of Pulmonary Nodules ≤2.0 cm in Diameter on Computed Tomography

Jun Sugihara^1,4, Hiroaki Takeyama¹, Tatsuhiko Kamoshida¹, Chuta Okawa¹, Yoji Kawaguchi¹, Tamon Yagi¹, Satoko Hanada¹, Reiko Taki¹, Katsuo Kojima², Urara Sakurai^3
1Department of Respiratory Medicine, Musashino Red Cross Hospital, Japan, ²Department of Thoracic Surgery, Karatsu Red Cross Hospital, Japan, ³Department of Pathology, Musashino Red Cross Hospital, Japan, ⁴Department of Respiratory Medicine, Kashiwa Municipal Hospital, Japan

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Objective. There is a certain risk of unnecessarily dissecting small pulmonary nodules found by computed tomography (CT). An appropriate guidance for preventing such unnecessary treatments is needed. Method. We selected pulmonary nodules ≤2.0 cm in diameter that had been surgically dissected from April 2010 to October 2016. We then analyzed the relationship between the imaging findings, pre-operative examination findings and pathological diagnosis. Result. A total of 270 lesions from 237 patients were included in the study. Concave, polygonal nodules had similar proportions for both benign and malignant diagnoses. Of the 17 patients whose clinical and pathological diagnoses were discrepant, 8 had concave, polygonal nodules. We considered these lesions difficult to evaluate correctly based on CT findings. Conclusion. Malignancy can be particularly difficult to distinguish via CT for pulmonary nodules with a concave, polygonal shape that are ≤2.0 cm in diameter, and a careful evaluation is necessary.
key words: Pulmonary nodule, Early diagnosis, Small lung cancer, High-resolution CT, Diagnostic imaging

Received: February 14, 2019
Accepted: November 13, 2019

JJLC 60 (1): 17-26, 2020