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Bakshi N, Nayar S, Kalra S, Duggal R. Adenosquamous carcinoma lung radiologically mimicking pneumonia: A potentially disastrous diagnostic challenge in an unusual malignancy. J Cancer Res Ther 2023; 19:839-841. [PMID: 37470624 DOI: 10.4103/jcrt.jcrt_2174_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Lung cancer is among the most frequently diagnosed cancers and the world's leading cause of cancer-related death. Radiology remains the mainstay for timely diagnosis; however, atypical radiologic patterns are known, and these may be misdiagnosed as infectious or inflammatory pathology, particularly in the absence of smoking history. We report herein an account of an older male nonsmoker who presented radiologically with bilateral diffuse pulmonary infiltrates, simulating pneumonia, but was eventually diagnosed with adenosquamous lung carcinoma. The delay in diagnosis and subsequent unfortunate rapid deterioration of our patient serves as a reminder for clinicians to consider lung cancer in patients with clinical/radiologic findings suggestive of pneumonia, especially in nonsmokers or cases refractory to antibiotic therapy.
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Affiliation(s)
- Neha Bakshi
- Department of Histopathology and Cytopathology, BLK-MAX Hospital, New Delhi, India
| | - Sandeep Nayar
- Department of Respiratory Medicine and Intervention Pulmonology, BLK-MAX Hospital, New Delhi, India
| | - Sunny Kalra
- Department of Respiratory Medicine and Intervention Pulmonology, BLK-MAX Hospital, New Delhi, India
| | - Rajan Duggal
- Department of Histopathology and Cytopathology, BLK-MAX Hospital, New Delhi, India
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2
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Marin AC, Prasad A, Patel V, Lwoodsky C, Hechter S, Imtiaz A, Patel P, Shah V, Appiah J, Cheriyath P. Pulmonary Adenocarcinoma Mimicking Pneumonia in a Young Adult. Cureus 2023; 15:e35267. [PMID: 36968868 PMCID: PMC10035766 DOI: 10.7759/cureus.35267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Lung cancer is the third most common cancer in the United States. Lung adenocarcinoma is a subtype of non-small cell lung cancer. On computed tomography (CT) it can appear as ground glass nodules, consolidative opacity, or solid mass lesions located in the periphery. Because it can appear as a consolidation, it can sometimes be confused with an infectious process such as pneumonia. We present a case of a 27-year-old male initially diagnosed with pneumonia; however, three months later, when he presented to the hospital with worsening pleuritic chest pain, fever, and dyspnea after a bronchoscopy a week before admission, pathology was positive for adenocarcinoma.
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Xiang Y, Zhang M, Zhao W, Shi H. Differentiation of localized pneumonic-type lung adenocarcinoma from localized pulmonary inflammatory lesion based on clinical data and multi-slice spiral computed tomography imaging features. Transl Cancer Res 2023; 12:113-124. [PMID: 36760374 PMCID: PMC9906051 DOI: 10.21037/tcr-22-2525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Background Localized pneumonic-type lung adenocarcinoma (L-PLADC) is a special type of lung adenocarcinoma, which mimicking localized pulmonary inflammatory lesion (L-PIL), and many delayed diagnoses of L-PLADC have been identified due to insufficient clinical understanding or the lack of knowledge regarding the radiological findings. Multi-slice spiral computed tomography (MSCT) not only observes the fine structure of the lesion clearly, but also can evaluate the lesion and its surrounding tissues more intuitively, stereoscopically, and accurately using a variety of reconstruction techniques. The present study aimed to investigate the diagnostic value of clinical data and MSCT imaging features in differentiating L-PLADC from L-PIL. Methods The clinical data and chest MSCT imaging features of 71 patients with L-PLADC and 70 patients with L-PIL were retrospectively analyzed. Seventy-one patients with L-PLADC underwent surgical resection or puncture and were confirmed as having invasive adenocarcinoma by pathology. Seventy patients with L-PIL were confirmed by clinical anti-inflammatory treatment or by puncture and surgery. The Chi-square and Mann-Whitney U tests were used to analyze the clinical data and MSCT imaging features of the included patients. Variables with P<0.05 in the univariate analysis were included in the multivariate logistic regression analysis to determine the independent risk factors for the diagnosis of L-PLADC. Results The clinical data analysis showed that multivariate logistic regression analysis showed that irregular air bronchogram [odds ratio (OR) =15.946; P<0.001], ground-glass opacity (GGO) component (OR =12.369; P<0.001), pleural traction (OR =10.982; P<0.001), necrosis (OR =0.078; P<0.001), adjacent bronchial wall thickening (OR =0.017; P<0.001), pleural thickening (OR =0.074; P<0.001), and respiratory symptoms were independent risk factors for the diagnosis of L-PLADC [OR =0.117; the area under the curve (AUC), sensitivity, specificity, and accuracy values were 0.989, 97.2%, 94.3%, and 95.7%, respectively]. Conclusions L-PLADC and L-PIL exhibit different clinical and MSCT imaging features. Determining these characteristics is conducive to the early diagnosis and clinical treatment of L-PLADC.
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Affiliation(s)
- Yisi Xiang
- Department of Radiology, Xuancheng People’s Hospital of Anhui Province, Xuancheng, China
| | - Min Zhang
- Department of Radiology, Xuancheng People’s Hospital of Anhui Province, Xuancheng, China
| | - Weiyan Zhao
- Department of Radiology, Xuancheng People’s Hospital of Anhui Province, Xuancheng, China
| | - Hengfeng Shi
- Department of Radiology, Anqing Municipal Hospital of Anhui Province, Anqing, China
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Li Q, Fan X, Huo JW, Luo TY, Huang XT, Gong JW. Differential diagnosis of localized pneumonic-type lung adenocarcinoma and pulmonary inflammatory lesion. Insights Imaging 2022; 13:49. [PMID: 35316418 PMCID: PMC8941022 DOI: 10.1186/s13244-022-01200-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/20/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In clinical practice, a number of delayed diagnoses of localized pneumonic-type lung adenocarcinoma (L-PLADC) mimicking pneumonia have been identified due to the lack of knowledge regarding the radiological findings associated with this condition. Here, we defined L-PLADC as a special type of lung adenocarcinoma that presents as a focal consolidation involving < 50% of the area of a lobe and aimed to investigate the differential clinical and imaging features between L-PLADC and localized pulmonary inflammatory lesion (L-PIL). RESULTS The data of 120 patients with L-PLADC and 125 patients with L-PIL who underwent contrast-enhanced chest computed tomography (CT) scan were retrospectively analyzed. For clinical characteristics, older age, women, nonsmokers, and no symptom were more common in L-PLADC (all p < 0.001). With regard to CT features, air bronchogram, irregular air bronchogram, ground-glass opacity (GGO) component, and pleural retraction were more frequently observed in L-PLADC, while necrosis, satellite lesions, halo sign, bronchial wall thickening, interlobular septa thickening, pleural attachment, and pleural thickening were more commonly seen in L-PIL (all p < 0.001). Multivariate analysis showed age ≥ 58 years, female sex, GGO component, irregular air bronchogram, pleural retraction, and the absence of necrosis and pleural attachment were the most effective variations associated with L-PLADC with an AUC of 0.979. Furthermore, an external validation cohort containing 62 patients obtained an AUC of 0.929. CONCLUSIONS L-PLADC and L-PIL have different clinical and imaging characteristics. An adequate understanding of these differential features can contribute to the early diagnosis of L-PLADC and the subsequent therapeutic strategy.
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Affiliation(s)
- Qi Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Xiao Fan
- Department of Radiology, Children's Hospital of Chongqing Medical University, No. 136 Zhongshan Road Two, Yuzhong District, Chongqing, 400014, China
| | - Ji-Wen Huo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Tian-You Luo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Xing-Tao Huang
- Department of Radiology, The Fifth People's Hospital of Chongqing, No. 24 Renji Road, Nan'an District, Chongqing, 400062, China.
| | - Jun-Wei Gong
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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Huo JW, Huang XT, Li X, Gong JW, Luo TY, Li Q. Pneumonic-type lung adenocarcinoma with different ranges exhibiting different clinical, imaging, and pathological characteristics. Insights Imaging 2021; 12:169. [PMID: 34787725 PMCID: PMC8599601 DOI: 10.1186/s13244-021-01114-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/25/2021] [Indexed: 02/08/2023] Open
Abstract
Background Pneumonic-type lung adenocarcinoma (PLADC) with different ranges might exhibit different imaging and clinicopathological features. This study divided PLADC into localized PLADC (L-PLADC) and diffuse PLADC (D-PLADC) based on imaging and aimed to clarify the differences in clinical, imaging, and pathologic characteristics between the two new subtypes. Results The data of 131 patients with L-PLADC and 117 patients with D-PLADC who were pathologically confirmed and underwent chest computed tomography (CT) at our institute from December 2014 to December 2020 were retrospectively collected. Patients with L-PLADC were predominantly female, non-smokers, and without respiratory symptoms and elevated white blood cell count and C-reactive protein level, whereas those with D-PLADC were predominantly male, smokers, and had respiratory symptoms and elevated white blood cell count and C-reactive protein level (all p < 0.05). Pleural retraction was more common in L-PLADC, whereas interlobular fissure bulging, hypodense sign, air space, CT angiogram sign, coexisting nodules, pleural effusion, and lymphadenopathy were more frequent in D-PLADC (all p < 0.001). Among the 129 patients with surgically resected PLADC, the most common histological subtype of L-PLADC was acinar-predominant growth pattern (76.7%, 79/103), whereas that of D-PLADC was invasive mucinous adenocarcinoma (80.8%, 21/26). Among the 136 patients with EGFR mutation status, L-PLADC had a significantly higher EGFR mutation rate than D-PLADC (p < 0.001). Conclusions L-PLADC and D-PLADC have different clinical, imaging, and pathological characteristics. This new imaging-based classification may help improve our understanding of PLADC and develop personalized treatment plans, with concomitant implications for patient outcomes.
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Affiliation(s)
- Ji-Wen Huo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yu zhong District, Chongqing, 400016, China
| | - Xing-Tao Huang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yu zhong District, Chongqing, 400016, China
| | - Xian Li
- Department of Pathology, Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Jun-Wei Gong
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yu zhong District, Chongqing, 400016, China
| | - Tian-You Luo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yu zhong District, Chongqing, 400016, China
| | - Qi Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yu zhong District, Chongqing, 400016, China.
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Han J, Wu C, Wu Y, Deng H, Gao J, Han H, Xue X. Comparative study of imaging and pathological evaluation of pneumonic mucinous adenocarcinoma. Oncol Lett 2021; 21:125. [PMID: 33552246 PMCID: PMC7798099 DOI: 10.3892/ol.2020.12386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/12/2020] [Indexed: 01/15/2023] Open
Abstract
Patients with pneumonia-type lung cancer (PTLC) do not exhibit specific clinical features, which makes imaging diagnosis difficult. Therefore, the aetiology of the pathological changes occurring during PTLC remains unclear. The current study aimed to explore the possible mechanism of PTLC formation by CT scans and pathological analysis of the lungs. A retrospective analysis was conducted on the CT and pathological data of 17 cases of PTLC. The diagnosis of lung cancer was confirmed by pathology. The CT scans of nine patients indicated diffuse distribution of lesions in the lungs, whereas those of three patients indicated single-lung multi-leaf distribution, and those of the remaining five patients included single-leaf distribution. All patients demonstrated increased plaque or patchy density in the majority of the lesions located near the heart. The pathological types of the identified tumours were mucinous adenocarcinoma with adherent growth as the main sub-type. A large number of mucus lakes were observed, containing floating tumour cells, as determined by optical microscopy. In addition, a number of tumour cells were located in the residual alveolar wall of the observed mucus lakes. The results of the present study suggested that the mucinous adenocarcinoma tumour cells produced substantial quantities of mucus, and that the cells were scattered and planted along with the mucus through the airway, which led to possible development of pneumonia-type mucinous adenocarcinoma.
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Affiliation(s)
- Jun Han
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, P.R. China
| | - Chongchong Wu
- Department of Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Yuxin Wu
- Department of Radiology, The Traditional Chinese Medicine Hospital of Changshou District, Chongqing 401220, P.R. China
| | - Hui Deng
- Department of Respiratory Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
| | - Jie Gao
- Department of Pathology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Hua Han
- Department of Radiology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Xinying Xue
- Department of Respiratory Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
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Chatterjee A, Sen Dutt T, Ghosh P, Mukhopadhyay S, Chandra A, Sen S. Inflammatory Lesions Mimicking Chest Malignancy: CT, Bronchoscopy, EBUS, and PET Evaluation From an Oncology Referral Center. Curr Probl Diagn Radiol 2021; 51:235-249. [PMID: 33483189 DOI: 10.1067/j.cpradiol.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
Infective and inflammatory diseases can mimic malignancy of the lung. Granulomatous inflammations are common causes of pulmonary nodule, mass, or nodal disease. Systemic infection or inflammation also commonly involves the lung that may raise suspicion of a malignant process. Even in patients with a known malignancy, inflammatory diseases can simulate new metastasis or disease progression. Knowledge of the imaging features of these diseases is essential to prevent missed or overdiagnosis of malignancy. Radiologists also need to be familiar with the scope and limitations of bronchoscopy, endobronchial ultrasound, PET-CT, and biopsy to guide clinical management. In this review, we discuss the imaging features and diagnostic approach of common mimickers of chest malignancy that involve the chest wall, pleura, lung parenchyma, and mediastinal nodes.
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Affiliation(s)
- Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India.
| | - Tiyas Sen Dutt
- Department of Pulmonology, Tata Medical Center, Kolkata, West Bengal, India
| | - Priya Ghosh
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Aditi Chandra
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Saugata Sen
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
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8
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Zong Q, Zhu F, Wu S, Peng L, Mou Y, Miao K, Wang Q, Zhao J, Xu Y, Zhou M. Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor. TUMORI JOURNAL 2020; 107:216-225. [PMID: 32762285 DOI: 10.1177/0300891620947159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE To retrospectively explore the survival predictors and treatment efficacy of advanced pneumonic-type lung adenocarcinoma (P-ADC). METHODS Retrospective analysis of clinical data and survival follow-up was undertaken on 41 patients with advanced P-ADC from January 1, 2009, to April 30, 2019. Analysis on tumor biomarkers such as carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and the cytokeratin-19-fragment (Cyfra21-1) were undertaken. The patients in this study were divided into three groups based on usage of tyrosine kinase inhibitor (TKI): TKI therapy group (including combination with chemotherapy), non-TKI therapy group (chemotherapy alone), and palliative care group. RESULTS More than half of the patients had higher levels of tumor biomarkers and the incidence of NSE was highest (81.8%), followed by CEA (74.4%) and Cyfra21-1 (74.1%). All patients had abnormal findings on chest computed tomography and with adenocarcinoma pathology. The overall survival (OS) time was 10.4 months in TKI group, 8.8 months in the non-TKI group, and 2.1 months in the palliative care group. Patients with higher level of serum Cyfra21-1 had insignificantly shorter survival time compared to those with normal Cyfra21-1 (p = 0.067). TKI therapy and non-TKI therapy provided a better prognosis prediction compared to palliative care. TKI therapy improved prognosis compared to non-TKI therapy. The comprehensive based TKI therapy provided improved OS vs the non-TKI therapy. CONCLUSION TKI-based therapy could improve the prognosis and OS for advanced P-ADC. This study recommends the analysis of EGFR mutations for all patients with advanced P-ADC.
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Affiliation(s)
- Qiu Zong
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Zhu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shimin Wu
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Li Peng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Mou
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kang Miao
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Wang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianping Zhao
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongjian Xu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Zhou
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Daoud A, Laktineh A, El Zein S, Soubani AO. Unusual presentation of primary lung adenocarcinoma mimicking pneumonia: Case report and literature review. Respir Med Case Rep 2019; 28:100881. [PMID: 31249777 PMCID: PMC6586773 DOI: 10.1016/j.rmcr.2019.100881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
Primary lung adenocarcinoma, diffuse pneumonic type, can mimic the clinical presentation of an infectious or inflammatory lung disease, which can represent a diagnostic challenge. We present an unusual case of adenocarcinoma of the lung refractory to treatment, associated with rapid deterioration of respiratory status, ARDS requiring intubation and ultimately death.
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Affiliation(s)
- Asil Daoud
- Internal Medicine Department, Wayne State University School of Medicine, Detroit, MI, United States
- Corresponding author. 4201 St. Antoine Street, Suite 2E, Detroit, MI 48201, United States.
| | - Amir Laktineh
- Internal Medicine Department, Wayne State University School of Medicine, Detroit, MI, United States
| | - Said El Zein
- Internal Medicine Department, Wayne State University School of Medicine, Detroit, MI, United States
| | - Ayman O. Soubani
- Internal Medicine Department, Division of Pulmonary and Critical Care Medicine, Wayne State University School of Medicine, Detroit, MI, United States
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10
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Yu H, Liu S, Zhang C, Li S, Ren J, Zhang J, Xu W. Computed tomography and pathology evaluation of lung ground-glass opacity. Exp Ther Med 2018; 16:5305-5309. [PMID: 30542487 DOI: 10.3892/etm.2018.6886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/03/2017] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to investigate the pathogenesis of lung ground-glass opacity (GGO) and the diagnostic value of computed tomography scan for lung GGO. Computed tomography (CT) images of 106 lung GGO cases were analyzed retrospectively, and the type, location, size, structure, boundaries and surrounding lung fields were evaluated. There were 12 cases of GGO with a diameter <1.0 cm, 36 cases with diameter of 1.0-1.5 cm, 25 cases with diameter of 1.6-2.0 cm, 19 cases with diameter of 2.0-2.5 cm and 14 cases with diameter of 2.5-3.0 cm. There were 20 lesions with a round shape and 68 lesions with an oval shape. There were 56 lesions with spinous processes, 18 lesions with air bronchograms and 37 lesions with surrounding pleural indentation. The diagnosis and differential diagnosis of GGO would be improved with combined CT scan and pathology results.
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Affiliation(s)
- Hualong Yu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Shihe Liu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Chuanyu Zhang
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Shaoke Li
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Jianan Ren
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Jingli Zhang
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
| | - Wenjian Xu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266101, P.R. China
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Lv J, Zhang H, Ma J, Ma Y, Gao G, Song Z, Yang Y. Comparison of CT radiogenomic and clinical characteristics between EGFR and KRAS mutations in lung adenocarcinomas. Clin Radiol 2018; 73:590.e1-590.e8. [DOI: 10.1016/j.crad.2018.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 01/11/2018] [Indexed: 01/26/2023]
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12
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Cao Y, Xu H. A new predictive scoring system based on clinical data and computed tomography features for diagnosing EGFR-mutated lung adenocarcinoma. ACTA ACUST UNITED AC 2018; 25:e132-e138. [PMID: 29719437 DOI: 10.3747/co.25.3805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background We aimed to develop a new EGFR mutation-predictive scoring system to use in screening for EGFR-mutated lung adenocarcinomas (lacs). Methods The study enrolled 279 patients with lac, including 121 patients with EGFR wild-type tumours and 158 with EGFR-mutated tumours. The Student t-test, chi-square test, or Fisher exact test was applied to discriminate clinical and computed tomography (ct) features between the two groups. Using a principal component analysis (pca) model, we derived predictive coefficients for the presence of EGFR mutation in lac. Results The EGFR mutation-predictive score includes sex, smoking history, homogeneity, ground-glass opacity (ggo) on imaging, and the presence of pericardial effusion. The pca predictive model took this form: [Formula: see text]Model scores ranged from 79 to 147. The area under the receiver operating characteristic curve was 0.752 [95% confidence interval (ci): 0.697 to 0.801] in the lac population at the optimal cut-off value of 109, and the sensitivity and specificity were 68.4% (95% ci: 60.5% to 75.5%) and 74.4% (95% ci: 65.6% to 81.9%) respectively. Conclusions The EGFR mutation risk scoring system based on clinical data and ct features is noninvasive and user-friendly. The model appears to frame a positive predictive value and was able to determine the value of repeating a biopsy if tissue is limited.
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Affiliation(s)
- Y Cao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R.C
| | - H Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R.C
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13
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Associations between clinical data and computed tomography features in patients with epidermal growth factor receptor mutations in lung adenocarcinoma. Int J Clin Oncol 2017; 23:249-257. [PMID: 28988295 PMCID: PMC5882627 DOI: 10.1007/s10147-017-1197-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/22/2017] [Indexed: 10/31/2022]
Abstract
BACKGROUND To analyse the differences in computed tomography (CT) features between patients with lung adenocarcinoma who have epidermal growth factor receptor (EGFR) mutations and those who have wild-type EGFR. METHODS Patients with lung adenocarcinoma (n = 156) were enrolled from October 2013 to March 2016, including 56 patients with wild-type EGFR and 100 patients with EGFR mutations. Two independent radiologists evaluated patient characteristics and imaging features. Chi-squared test, Fisher's exact test or ANOVA was applied to discriminate clinical and CT characteristics between the genotypes. A prediction tool for EGFR mutation was devised from principal component analysis. RESULTS The proportion of females and non-smokers in the exon 19 deletion and exon 21 missense groups was higher than in the wild-type group (P < 0.01). Severe emphysema was higher in the wild-type group than in the exon 19 deletion group (P < 0.01). The maximum diameter in the mediastinal window (MaxDmediastinal) in the wild-type group was longer than in the exon 19 deletion and exon 21 missense groups. The minimum diameter in the mediastinal window (MinDmediastinal) in the wild-type group was also longer than in the exon 21 missense group, with a significant difference (P < 0.05). The tumor shadow disappearance rate (TDR) in the exon 19 deletion group was higher than in the wild-type group. Ground glass opacity (GGO) appeared to be more common in the exon 19 deletion group (P = 0.010). The prediction score for exon 19 deletion mutation was: 0.305 × gender + 0.254 × smoking history + 0.198 × MaxDmediastinal + TDR × 0.254 + 0.280 × GGO + 0.095 × emphysema. The sensitivity and specificity for predicting exon 19 deletion were 59.09 and 76.79%, respectively. The prediction score for the exon 21 missense mutation was: 0.354 × gender + 0.291 × smoking history + 0.410 × MaxDmediastinal + 0.408 × MinDmediastinal. The sensitivity and specificity for predicting exon 21 missense mutation were 72.34 and 78.57%, respectively. CONCLUSION As well as gender, smoking history and GGO, adenocarcinomas with EGFR mutation were significantly associated with emphysema, TDR, and the diameter in the mediastinal window. As exon 19 deletion and 21 missense mutations might be predicted by those features, the scoring system might be valuable for clinical diagnosis.
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Rizzo S, Petrella F, Passaro A, de Marinis F, Bellomi M. Proposals for revisions of the classification of lung cancers with multiple pulmonary sites: the radiologist's, thoracic surgeon's and oncologist's point of view. J Thorac Dis 2016; 8:E805-8. [PMID: 27618872 DOI: 10.21037/jtd.2016.07.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Stefania Rizzo
- Division of Radiology, European Institute of Oncology, Milan, Italy
| | - Francesco Petrella
- Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy
| | - Antonio Passaro
- Division of Thoracic Oncology, European Institute of Oncology, Milan, Italy
| | - Filippo de Marinis
- Division of Thoracic Oncology, European Institute of Oncology, Milan, Italy
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15
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Liu Y, Zhao Y, Qin Y, Du X, Wang Q, Lyu J. A novel microfluidic device that integrates nucleic acid extraction, amplification, and detection to identify an EGFR mutation in lung cancer tissues. RSC Adv 2016. [DOI: 10.1039/c5ra26225a] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel microfluidic to detect a EGFR mutation in 40 min in an easy way for personalized medicine.
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Affiliation(s)
- Yuanbin Liu
- Key Laboratory of Laboratory Medicine
- Ministry of Education
- Zhejiang Provincial Key Laboratory of Medical Genetics
- Wenzhou Medical University
- Wenzhou
| | - Yang Zhao
- Department of Respiratory Medicine
- The Second Hospital
- Dalian Medical University
- Dalian 116023
- China
| | - Yongxin Qin
- Emergency Department
- The First Hospital
- Dalian Medical University
- Dalian 116011
- China
| | - Xiaohui Du
- Scientific Research Center
- The Second Hospital
- Dalian Medical University
- Dalian 116023
- China
| | - Qi Wang
- Department of Respiratory Medicine
- The Second Hospital
- Dalian Medical University
- Dalian 116023
- China
| | - Jianxin Lyu
- Key Laboratory of Laboratory Medicine
- Ministry of Education
- Zhejiang Provincial Key Laboratory of Medical Genetics
- Wenzhou Medical University
- Wenzhou
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