We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers.
Computed tomography scans, including thin-section high-resolution computed tomography (HRCT), occasionally fail to differentiate between small non-cancerous nodules from lung cancers. We describe nine such lesions ( < 20 mm in diameter) initially identified through our screening program for lung cancer using CT scanning. Pathological diagnoses included nodular fibrosis (n = 4), granuloma (n = 1), cryptococcoma (n = 1), localised organising pneumonia (n = 1), inflammatory pseudo-tumour (n = 1) and sclerosing haemangioma (n = 1). High-resolution CT findings, together with MRI findings with contrast-enhanced dynamic studies, were retrospectively evaluated. Additional cases should be identified and radiologically characterised in order to reduce the number of non-cancerous tumours that are treated by unnecessary surgery.
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