No abstract available.
Solitary Pulmonary Nodule*

No abstract available.
Myocardial Ischemia* ; Solitary Pulmonary Nodule*

PURPOSE: To evaluate the usefulness of contrast-enhanced dynamic MR imaging for differentiation of benign andmalignant solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: Twenty-three patients with histologically orradiologically provened SPNs smaller than 40mm (14 benign, 9 malignant) underwent MR examination using the breathhold fast multiplanar spoiled gradient echo (FMPSPGR) technique. Pre-enhancement MR examination wasfollowed by serial scans obtained at one-minute intervals, beginning one-minute after the onset of bolus injectionof paramagnetic contrast agent for a total of five scans. Signal intensities of SPNs were measured from pre- andpost-contrast enhanced MR images and peak percentage increase in signal intensity (p%SI) was calculated. Meanpercentage increase in signal intensity (m%SI) was also calculated and the time-m%SI curve was plotted. The enhancement patterns of SPNs were classified as homogeneous, peripheral rim-like, inhomogeneous, or no (orminimal) enhancement. We compared differences in p%SI, the pattern of the time-m%SI curve, and the pattern ofenhancement between benign and malignant SPNs. RESULTS: On dynamic MR images, alignant SPNs (n=9) showed asignificantly higher p%SI than benign SPNs (n=14) (malignant: mean 120.6, range 81.8-171.6; benign: mean 29.5,range 3.7-78.9) (p < 0.0001). With 80 p%SI as the threshold for malignancy-positive, both sensitivity andspecificity were 100%. The m%SI of malignant SPNs rapidly increased at one minute after enhancement and decreasedgradually thereafter, whereas that of benign SPNs increased more slowly to form a plateau. Eighty-nine percent(8/9) of malignant SPNs showed homogeneous enhancement. In contrast, among benign SPNs, peripheral rim-likeenhancement and no (or minimal) enhancement occurred in the same proportion of cases: 50% (7/14). CONCLUSION:The superb demonstration of different enhancement characteristics obtained using dynamic contrast-enhanced MRimaging is useful to discriminate malignant from benign SPNs.
Humans ; Magnetic Resonance Imaging ; Solitary Pulmonary Nodule*

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: We are now detecting an increasing number of solitary pulmonary nodules (SPNs) that are difficult to diagnosis. The purpose of this study was to evaluate the useful radiologic findings for differentiating benign from malignant pulmonary nodules. MATERIAL AND METHOD: The high-resolution CT (HRCT) findings of SPNs smaller than 3 cm in largest diameter were evaluated in 134 patients with malignant and benign nodules in regard to internal structures, margin characteristics, and surrounding parenchymal responses. RESULT: The nodules with the area of ground-glass attenuation (GGA) greater then 50% were noted in adenocarcinoma, inflammatory lesions and some of metastatic tumors, and the lesions greater than 90% were noted only in adenocarcinoma. The area of GGA in non-adenocarcinoma, benign tumors and tuberculomas were less than 50%, and mainly less than 10%. The findings of air bronchogram, spiculation, lobulation, vascular involvement, and pleural indentation were some noted at every types of malignant tumors, but especially high over than 30% in adenocarcinomas. CONCLUSION: Most peripheral lung adenocarcinomas form a characteristic radiologic findings especially in HRCT. Evaluation of these findings would be helpful in differentiating between lung cancer, especially adenocarcinoma, and other lesions.
Adenocarcinoma ; Diagnosis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Tuberculoma

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.
Adenocarcinoma ; Lung Neoplasms ; Risk Factors ; Solitary Pulmonary Nodule ; Tuberculoma

Primary intrapulmonary thymoma (PIT) is a very rare lesion of uncertain pathogenesis. PIT should be considered when the histopathological appearance of a lung tumor shows features that are uncommon but similar to those of a thymoma. In this case report, we discuss the case of a 59-year-old female with a solitary pulmonary nodule that was confirmed to be PIT on the basis of pathological tests. Treatment with complete resection showed good results.
Diagnosis ; Female ; Humans ; Lung ; Middle Aged ; Solitary Pulmonary Nodule* ; Thymoma*