Paediatric pulmonary nodules: a comparison of computed tomography, thoracotomy findings and histology

Metastases detected at the time of diagnosis of primary pediatric extremity osteosarcoma at diagnosis

“…However, in light of histologically proven pulmonary metastases occurring in 87% (20 of 23) of those who underwent thoracotomy because of persistent pulmonary nodules, the likelihood of a pulmonary nodule representing metastatic OS is very high. This high incidence of pulmonary nodules representing metastatic disease in children with extremity OS coincides with that found by Robertson et al 21 The number and distribution of pulmonary nodules and their effect on overall survival warrants comment. Our study demonstrates that not only the number of pulmonary metastases but also their distribution among pulmonary lobes affect survival.…”

Indeterminate Pulmonary Nodules in Patients with Sarcoma Affect Survival

“…This finding is supported by a small series of pediatric sarcoma patients that suggested pulmonary nodules smaller than 5 mm were of no clinical significance. 7 Additional staging modalities (if indicated) for indeterminate nodules, such as biopsy or serial CCT/positron emission tomography, are therefore best directed for nodules 5 mm or larger.…”

Prognostic factors and imaging patterns of recurrent pulmonary nodules after thoracotomy in children with osteosarcoma

“…20,21 Crow et al 20 described a distinctive pattern of pleural metastases that appeared on macroscopic examination as lesions approximately 2mm by 5-10mm, which the authors maintained were unlikely to be detected by CT. Our results support this conclusion. The five patients who had microscopic evidence of pleural seeding had no CT evidence of pleural disease either before or after thoracotomy.…”