Multiple Focal Pure Ground-glass Opacities on HRCT Images: Clinical Significance
in Patients with Lung Cancer
Jing XIAO1, Yufen WU1, Liang XU2, Yong HUANG2, Yuhui LIU2
1Department of Radioligy, Affiliated Hospital of Shandong Academy of Medical Sciences, Ji’nan 250031, China;
2Department of Radioligy, Tumor Hospital of Shandong Province, Ji’nan 250117, China
Corresponding author: Yong HUANG, E-mail: huangyong1970888@sina.com;
Yuhui LIU, E-mail: lyh7602@126.com
【Abstract】Background and objective Some cases of lung cancer in addition to a primary tumor are associated
with multiple pure ground-glass opacities (pGGOs). The objective of this study is to evaluate the clinical significance of multiple
pGGOs on CT images of patients with lung cancer. The number, size, distribution, and morphological characteristics of the
pGGOs were evaluated. Serial changes in pGGOs that were not surgically resected were analyzed at follow-up CT. Methods The cases of 25 patients with proven lung cancer and associated multiple pGGOs on CT images were retrospectively reviewed.
Results In total, 207 pGGOs were detected. The size of the opacities ranged from 2 mm to 31 mm in largest diameter. Lung
cancer and pGGOs were seen in the same lobe and/or in other lobes. Of the lesions, 183 (88.4%) had a round shape or welldefined
border. Histological findings were obtained for 17 lesions representing 87 pGGOs that were surgically resected, namely,
13 atypical adenomatous hyperplasias, 3 bronchioloalveolar carcinomas, and 1 focal fibrosis. Of the 120 pGGOs followed up
with CT for a median duration of 61.5 months, 113 (94.2%) retained their size, 1 decreased in size, and 6 disappeared. Conclusion The size of most pGGOs associated with lung cancer did not change during the follow-up period. Most of the lesions
histologically diagnosed were atypical adenomatous hyperplasias or bronchioloalveolar carcinomas. The results justify the
therapeutic strategy of resecting the primary tumor without therapeutic intervention in the remaining pGGOs.
【Key words】Lung neoplasms; Atypical adenomatous hyperplasia; Bronchioloalveolar carcinoma; Focal pure
ground-glass opacity; Computed tomography