Predictors for Benign Solitary Pulmonary Nodule in Tuberculosis-Endemic Area.
- Author:
Hojoong KIM
1
;
Soo Jung KANG
;
Gee Young SUH
;
Man Pyo CHUNG
;
Jung KWON
;
Chong H RHEE
;
Kyung Jae JUNG
;
Tae Sung KIM
;
Kyung Soo LEE
Author Information
1. Division of Pulmonary and Critical Care Medicine, Departments of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Pulmonary Coin Lesion;
Risk Factors;
Malignancy
- MeSH:
Adult;
Age Factors;
Carcinoma/pathology/radiography;
Coin Lesion, Pulmonary/*pathology/*radiography;
Female;
Human;
Korea;
Lung Neoplasms/pathology/radiography;
Male;
Middle Age;
Multivariate Analysis;
Predictive Value of Tests;
Retrospective Studies;
Tomography, X-Ray Computed;
Tuberculosis, Pulmonary/*pathology/*radiography
- From:The Korean Journal of Internal Medicine
2001;16(4):236-241
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Solitary pulmonary nodule (SPN) may show different pre- sentation in tuberculosis (TB)-endemic countries. The aim of this study was to identify clinical and radiological predictors favoring benign or malignant SPN in TB-endemic region. METHODS: Two hundred one SPNs in 201 consecutive Korean patients were included (< 3 cm in diameter, all confirmed by pathology or bacteriology, 93 benign and 108 malignant diseases). For clinical parameters, age, sex, smoking status and amount, and past history of pulmonary tuberculosis and diabetes mellitus were investigated retrospectively. For radiological parameters, size, location, margin characteristics, presence of calcification, pleural tag, surrounding satellite nodule, cavitation, internal low attenuation, open bronchus sign, surrounding ground-glass opacity, enhancement pattern of the SPNs and mediastinal lymph node (LN) enlargement were analyzed on chest CT scans. RESULTS: Patients with a older age (60.7+/-9.6 vs 56.2+/-13.1, p=0.008) and more than 40-pack years smoking (27.8% vs 14.0%, p=0.017) were more frequently related with malignant than benign SPN. On chest CT scans, spiculated margin, contrast enhancement more than 20 Hounsfield unit and presence of pleural tag and mediastinal LN enlargement were more frequently observed in malignant than benign SPNs. In contrast to previous studies, satellite lesions (21.5% vs 1.9%, p < 0.001) and cavitation (20.4% vs 5.6%, p=0.001) were more frequently seen in benign than malignant SPN. Positive predictive values of benignity were 90.9% and 76.0%, respectively, when satellite lesions and cavitation were found in cases of SPN. CONCLUSION: Satellite lesions and cavitation on chest CT scan could be useful predictors for benign SPN in TB-endemic areas.
