CT Characteristics of Lung Nodules Present at Diagnosis of Extrapulmonary Malignancy in Children

Abstract

Lung nodules in children with extrapulmonary malignancies showed a variety of patterns on CT. In the subgroup of lung nodules that underwent biopsy, none of the nodule features studied on CT reliably differentiated benignity from malignancy.

Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

“…In contrast, the results of our study show that other imaging features (shape, margin, attenuation, location, and the presence of calcification and cavitation) of pulmonary nodules detected on CT studies are not helpful for predicting which pulmonary nodules are malignant in children. The results of our study correlate well with findings from a previous study that investigated the CT characteristics of pulmonary nodules present at diagnosis of extrapulmonary malignancies in children [9]. In their study, Silva et al [9] showed that pulmonary nodules in children with extrapulmonary malignancy demonstrated a variety of patterns on CT and none of the CT features could reliably differentiate benignity from malignancy.…”

“…The results of our study correlate well with findings from a previous study that investigated the CT characteristics of pulmonary nodules present at diagnosis of extrapulmonary malignancies in children [9]. In their study, Silva et al [9] showed that pulmonary nodules in children with extrapulmonary malignancy demonstrated a variety of patterns on CT and none of the CT features could reliably differentiate benignity from malignancy. Similar to their results, none of the features of the pulmonary nodules investigated showed association with the presence of underlying malignancy in our study, with the exception of nodule size.…”

“…These guidelines do not apply to children or pulmonary nodules detected on abdominal CT. Furthermore, although there are several previously published articles addressing pulmonary nodules seen in pediatric oncology patients [9][10][11], these studies did not specifically investigate the clinical significance of incidentally detected pulmonary nodules seen on abdominal CT studies in the nononcological pediatric population. We believe that practical guidelines for managing incidentally detected pulmonary nodules in children are urgently needed.…”

Pulmonary and Extrathymic Mediastinal Tumors

“…Due to its greater sensitivity for small lesions and precision for measuring the size of lesions, CT is routinely used in follow-up of treated malignancy. While CT is highly sensitive, it lacks specificity and cannot reliably differentiate between benign and malignant lung nodules (McCarville et al 2006;Silva et al 2010). Correlation with clinical history and serial imaging follow-up improves its specificity.…”

The incidental pulmonary nodule in a child

“…Yet the detection of incidentalomas occurs with relative frequency in children as well (mainly adrenal [10] and pulmonary in origin [11]), presumably related to the increase in the use of pediatric CT in recent years [12,13]. This, in combination with recent rapid technological advances in CT, has allowed for the routine detection of lung nodules as small as 1-2 mm on scans that cover all or part of the chest [11,14].…”