Multifocal IPMN of the branch ducts shows a very slow growth and evolution over time. In our study, only 3/108 patients showed mural nodules which, however, did not require any surgical procedure, indicating that careful nonoperative management may be safe and effective in asymptomatic patients.
SummaryBackgroundThe solitary pulmonary nodule (SPN) is a common radiologic abnormality on chest x-rays or computed tomography (CT) scans of the lungs. The differential diagnosis of SPNs is particularly wide as it includes a multitude of benign as well as malignant entities. Nodule location within the lungs has been proposed as a predictive feature in the literature. This study aims at illustrating the distribution within the lungs of a large current series of consecutive SPNs according to their histological subtype, which was definitely proved at core biopsy.Material/MethodsTwo hundred-eight SPNs referred to our center for characterization were reviewed in this single-centre retrospective study. Histological subtypes were defined following the IASLC/ATS/ERS and WHO (2004) histological classification.ResultsThis study provides evidence with respect to the prevalence of adenocarcinomas and other non-neuroendocrine primary lung cancer types in the right upper lobe. It also provides new evidence with respect to the prevalence of carcinoid tumors in the middle and right lower lobe, with a tendency to occur in the central lung parenchyma.ConclusionsThis work updates existing knowledge of solid SPNs location within the lungs by providing a current picture of SPN distribution according to their nature.
Objectives: To compare the conspicuity of lobular breast cancers at digital breast tomosynthesis (DBT) versus synthesized 2D mammography (synt2D). Materials and methods: Seventy-six women (mean age 61.2 years, range 50–74 years) submitted to biopsy in our institution, from 2019 to 2021, with proven invasive lobular breast cancer (ILC) were enrolled in this retrospective study. The participants underwent DBT and synt2D. Five breast radiologists, with different years of experience in breast imaging, independently assigned a conspicuity score (ordinal 6-point scale) to DBT and synt2D. Lesion conspicuity was compared, for each reader, between the synt2D overall conspicuity interpretation and DBT overall conspicuity interpretation using a Wilcoxon matched pairs test. Results: A total of 50/78 (64%) cancers were detected on both synt2D and DBT by all the readers, while 28/78 (26%) cancers where not recognized by at least one reader on synt2D. For each reader, in comparison with synt2D, DBT increased significantly the conspicuity of ILC (p < 0.0001). The raw proportion of high versus low conspicuity by modality confirmed that cancers were more likely to have high conspicuity at DBT than synt2D. Conclusions: ILCs were more likely to have high conspicuity at DBT than at synt2D, increasing the chances of the detection of ILC breast cancer.
SummaryBackgroundA disappearing or persistent solid pulmonary nodule is a neglected clinical entity that still poses serious interpretative issues to date. Traditional knowledge deriving from previous reports suggests particular features, such as smooth edges or regular shape, to be significantly associated with benignity. A large number of benign nodules are reported among smokers in lung cancer screening programmes.The aim of this single-center retrospective study was to correlate specific imaging features to verify if traditional knowledge as well as more recent acquisitions regarding benign SPNs can be considered reliable in a current case series of nodules collected in a non-smoker cohort of patients.Material/MethodsFifty-three solid SPNs proven as non-growing during follow-up imaging were analyzed with regard to their imaging features at thin-section CT, their predicted malignancy risk according to three major risk assessment models, minimum density analysis and contrast enhanced-CT in the relative subgroups of nodules which underwent such tests.ResultsEleven nodules disappeared during follow-up, 29 showed volume loss and 16 had a VDT of 1121 days or higher. There were 48 nodules located peripherally (85.71%). Evaluation of the enhancement after contrast media (n=29) showed mean enhancement ±SD of 25.72±35.03 HU, median of 18 HU, ranging from 0 to 190 HU. Minimum density assessment (n=30) showed mean minimum HU ±SD of −28.27±47.86 HU, median of −25 HU, ranging from −144 to 68 HU. Mean malignancy risk ±SD was 15.05±26.69% for the BIMC model, 17.22±19.00% for the Mayo Clinic model and 19.07±33.16% for the Gurney’s model.ConclusionsOur analysis suggests caution in using traditional knowledge when dealing with current small solid peripheral indeterminate SPNs and highlights how quantitative growth at follow-up should be the cornerstone of characterization.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.