Discriminating between bronchiolar adenoma, adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung with CT

Cao, Lanqing; Wang, Z.; Gong, Ting-Ting; Wang, J.; Liu, J.; Jin, Liang; Yuan, Qing

doi:10.1016/j.diii.2020.05.005

Cited by 13 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study confirmed that the overall incidence of postoperative VTE was 6.7%, which is similar to the incidence of VTE after lung resection for benign lesions (7%) in our previous study (5). Many previous studies have confirmed that AIS mostly appears as pure ground-glass opacities (p-GGOs) on imaging (15)(16)(17). In recent years, the widespread promotion and application of low-dose chest computed tomography (CT) has facilitated the detection of pulmonary nodules in many asymptomatic individuals.…”

Section: Discussionsupporting

confidence: 89%

Incidence of venous thromboembolism after surgery for adenocarcinoma in situ and the validity of the modified Caprini score: A propensity score-matched study

Cai

Dong

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundRecently, the new World Health Organization (WHO) tumor classification removed adenocarcinoma in situ (AIS) from the diagnosis of lung cancer. However, it remains unclear whether the “malignancy” item should be assessed when the modified Caprini Risk Assessment Model (RAM) is used to assess venous thromboembolism (VTE) risk in AIS. The purpose of our study is to assess differences between AIS and stage IA adenocarcinoma (AD) from a VTE perspective.MethodsA retrospective study was performed on AIS and IA adenocarcinoma in our hospital from January 2018 to December 2021, and divided into AIS group and AD group. Propensity score matching (PSM) was used to compare the incidence of VTE and coagulation function, and to analyze whether the RAM is more effective when the “malignancy” item is not evaluated in AIS.Results491 patients were included after screening, including 104 patients in the AIS group and 387 patients in the AD group. After PSM, 83 patients were matched. The incidence of VTE and D-dimer in the AIS group was significantly lower than that in the AD group (P<0.05).When using the RAM to score AIS, compared with retaining the “malignancy” item, the incidence of VTE in the intermediate-high-risk group was significantly higher after removing the item (7.9% vs. 36.4%, P=0.018), which significantly improved the stratification effect of the model.ConclusionsThe incidence of postoperative VTE in AIS was significantly lower than that in stage IA adenocarcinoma. The stratification effect was more favorable when the “malignancy” item was not evaluated in AIS using the RAM.

show abstract

Section: Discussionsupporting

confidence: 89%

Incidence of venous thromboembolism after surgery for adenocarcinoma in situ and the validity of the modified Caprini score: A propensity score-matched study

Cai

Dong

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Misdiagnosis of BA as invasive adenocarcinoma may lead to unnecessary interventional procedures, which leads to overtreatment of patients with BA (10). A previous study reported some CT imaging features, including pseudo-cavitation and tumor-lung interface, could help differentiate BA from AIS/MIA (2). In our study, the nodule type, tumor size, and pseudo-cavitation sign showed significant differences between BA and AIS/MIA.…”

Section: Discussionmentioning

confidence: 45%

“…The pseudo-cavitation sign, which is a CT imaging feature of BA, can also be seen in adenocarcinoma, bronchioalveolar carcinoma, and infectious pneumonia (24). However, the pseudo-cavitation sign was reported to be more frequently observed in BA than in AIS and MIA (2). In our cohort, the pseudo-cavitation sign was found in 66.67% of BA and 21.62% of AIS/MIA, similar to what has been reported in a previous study.…”

Section: Discussionmentioning

confidence: 99%

“…According to the proportion of mucous cells and ciliated cells on the luminal surface, BA is divided into proximal type and distal type. On computed tomography (CT) images, BA often presents as a peripheral irregular-shaped small solid nodule, groundglass nodule (GGN), or subsolid GGN with a central cavity (2,3), which could be easily misdiagnosed as adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA) (4). As subtypes of lung adenocarcinomas, AIS or MIA requires surgery and is not expected to recur if removed completely (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CT Texture Analysis for Differentiating Bronchiolar Adenoma, Adenocarcinoma In Situ, and Minimally Invasive Adenocarcinoma of the Lung

et al. 2021

View full text Add to dashboard Cite

Purpose: This study aimed to investigate the potential of computed tomography (CT) imaging features and texture analysis to distinguish bronchiolar adenoma (BA) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA).Materials and Methods: Fifteen patients with BA, 38 patients with AIS, and 36 patients with MIA were included in this study. Clinical data and CT imaging features of the three lesions were evaluated. Texture features were extracted from the thin-section unenhanced CT images using Artificial Intelligence Kit software. Then, multivariate logistic regression analysis based on selected texture features was employed to distinguish BA from AIS/MIA. Receiver operating characteristics curves were performed to determine the diagnostic performance of the features.Results: By comparison with AIS/MIA, significantly different CT imaging features of BA included nodule type, tumor size, and pseudo-cavitation sign. Among them, pseudo-cavitation sign had a moderate diagnostic value for distinguishing BA and AIS/MIA (AUC: 0.741 and 0.708, respectively). Further, a total of 396 quantitative texture features were extracted. After comparation, the top six texture features showing the most significant difference between BA and AIS or MIA were chosen. The ROC results showed that these key texture features had a high diagnostic value for differentiating BA from AIS or MIA, among which the value of a comprehensive model with six selected texture features was the highest (AUC: 0.977 or 0.976, respectively) for BA and AIS or MIA. These results indicated that texture analyses can effectively improve the efficacy of thin-section unenhanced CT for discriminating BA from AIS/MIA.Conclusion: CT texture analysis can effectively improve the efficacy of thin-section unenhanced CT for discriminating BA from AIS/MIA, which has a potential clinical value and helps pathologist and clinicians to make diagnostic and therapeutic strategies.

show abstract

“…BA manifests as pure ground-glass and subsolid lesions in CT, with ill-de ned peripheral opacity due to in ammatory in ltrates, while lobular/spiculated margins suggest the possibility of malignant invasion [9].…”

Section: Discussionmentioning

confidence: 99%

Proximal bronchiolar adenoma with malignant transformation to invasive mucinous adenocarcinoma with 4 years follow-up: A case report

Yin

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Bronchiolar adenoma (BA) is a rare benign tumor arising from the bronchiolar mucosal epithelium that mainly occurs in the periphery of lung. The most prominen histopathologic feature of BA is a bilayered bronchiolar-type epithelium containing a continuous basal cell layer. However, due to the high mutation frequency of driven genes, it is still controversial whether BA has malignant transformation potential. In frozen sections, basal cells are difficult to identify by microscopically, making it difficult to distinguish from non-mucinous adenocarcinoma, especially when malignant transformation of BA into invasive mucinous adenocarcinoma (IMA) occurs, it is only differentiated by histomorphology criteria, which greatly improves the difficulty of diagnosis. Case presentation: This paper, we report a case of a 59-year-old man. The chest computed tomography (CT) showed a high-density nodular gradually increased during 4 years in the outer basal segment of the right lower lobe, followed by thoracoscopic wedge resection of the right lower lobe. Postoperative pathological diagnosis was BA, with mucous gland structure formation combined with basal cell loss in partial region, considering malignant transformation into invasive mucinous adenocarcinoma. Regular postoperative follow-up showed no recurrence or metastasis. Hybridization Capture-based next-generation sequencing (NGS) eventually detected driver gene KRAS and CDK6 mutations in the case, and the results suggested the occurrence of malignant transformation from BA to IMA.Conclusion: In the nodular, the loss of continuity of the basal cell layer in the area of mucous glandular structures and the driver gene KRAS mutation indicate a malignant transformation of BA into IMA in this case, so we infer that BA has malignant potential.

show abstract

Discriminating between bronchiolar adenoma, adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung with CT

Cited by 13 publications

References 19 publications

Incidence of venous thromboembolism after surgery for adenocarcinoma in situ and the validity of the modified Caprini score: A propensity score-matched study

Incidence of venous thromboembolism after surgery for adenocarcinoma in situ and the validity of the modified Caprini score: A propensity score-matched study

CT Texture Analysis for Differentiating Bronchiolar Adenoma, Adenocarcinoma In Situ, and Minimally Invasive Adenocarcinoma of the Lung

Proximal bronchiolar adenoma with malignant transformation to invasive mucinous adenocarcinoma with 4 years follow-up: A case report

Contact Info

Product

Resources

About