Solitary Nodular Invasive Mucinous Adenocarcinoma of the Lung: Imaging Diagnosis Using the Morphologic-Metabolic Dissociation Sign

Jae, Min; Lee, Kyung Soo; Kim, Tae Jung; Kim, Hyun Su; Chung, Myung Jin; Kim, Byung Tae; Kim, Yang Soo

doi:10.3348/kjr.2018.0409

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Typical CT findings of IMA include multiple consolidations or ground-glass opacities mimicking pneumonia; however, there are some reports that a solitary nodule pattern is much more common than pneumonia pattern [ 2 , 6 ]. Pathological features of IMA are characterized by goblet or columnar tumor cells containing abundant cytoplasmic mucin, and a lepidic growth pattern with microscopic skip lesions [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Invasive Mucinous Adenocarcinoma of the Lung Presenting With Multiple Cavities

Nakamura¹,

Sugimoto²,

Negoro³

et al. 2021

Cureus

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A 78-year-old woman presented to our hospital with a two-week history of productive cough. Chest computed tomography (CT) showed bilateral multiple pulmonary nodules with cavities. Although the cytology of her sputum revealed adenocarcinoma, she refused any treatment. Following supportive care, 30 months later, she presented to our hospital with dyspnea and fever. Chest CT showed progression of multiple pulmonary nodules and cavities. Despite treatment with antibiotics and palliative care, she died on the 10th day of hospitalization. Pathological autopsy confirmed the diagnosis of pulmonary invasive mucinous adenocarcinoma (IMA). The typical CT findings of IMA include multiple consolidations or ground-glass opacities mimicking pneumonia; rarely, cavitary lesions are also observed. Clinicians should consider IMA as a differential diagnosis for lung cavities.

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Section: Discussionmentioning

confidence: 99%

Invasive Mucinous Adenocarcinoma of the Lung Presenting With Multiple Cavities

Nakamura¹,

Sugimoto²,

Negoro³

et al. 2021

Cureus

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“…Solitary nodular IMA has been reported to be prone to cavitary lung lesions (air bronchogram or vacuolar signs). 16 , 17 The pathological causes of these signs include: 1. Expulsion of mucus from mucus pools through the attached bronchi.…”

Section: Discussionmentioning

confidence: 99%

CT Features of Stage IA Invasive Mucinous Adenocarcinoma of the Lung and Establishment of a Prediction Model

Zhang¹,

Wang²,

Kang³

et al. 2022

IJGM

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Objective To investigate computed tomography (CT) features of stage IA invasive mucinous adenocarcinoma (IMA) of the lung and establish a predictive model. Methods Fifty-three lesions from 53 cases of stage IA IMA between January 2017 and December 2019 were examined, while 141 lesions from 141 cases of invasive non-mucinous lung adenocarcinoma (INMA) served as control cases. Univariate analysis was performed to compare differences in demographics and CT features between the two groups, and multivariate logistic regression analysis was performed to determine primary influencing factors of solitary nodular IMA. A risk score prediction model was established based on the regression coefficients of these factors, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the model. Results Univariate analysis showed that age, nodule type, maximum nodule diameter, tumor lung interface, lobulation, spiculation, air bronchogram or vacuolar signs, and abnormal vascular changes differed significantly between the two groups (p < 0.05). Compared to INMA, spiculation of IMA was relatively longer and softer. Multivariate logistic regression analysis showed that nodule type, indistinct tumor lung interface, air bronchogram or vacuolar signs, and abnormal vascular changes were the primary influencing factors. A prediction model based on the regression coefficients of these factors was established. ROC curve analysis indicated that the area under the curve was 0.882 (p < 0.05). Conclusion Compared to INMA, solitary peripheral stage IA nodular IMA were more common in older patients; they more frequently had indistinct tumor lung interface and air bronchogram or vacuolar signs on CT; spiculation was relatively longer and softer; our risk score prediction model based on nodule type, tumor lung interface, air bronchogram or vacuolar signs, and abnormal vascular changes was established with good predictive efficacy for solitary nodular IMA.

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“…Some reports (17,18) found that the CT value of lung cancer at the level of 40-70 Kev was higher than that of the tuberculosis group in the quantitative analysis of peripheral lung cancer and tuberculoma by energy spectrum. There were many reports on PET/ CT for PPMA (19,20), but there were no reports about CT features of PNMA and tuberculoma. In this study, we found that the CT value of tuberculoma on plain scan was 35.15±16.00, and the CT value of PNMA was 24.00±12.67.…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of pulmonary nodular mucinous adenocarcinoma and tuberculoma with dynamic CT: a retrospective study

Yin¹,

Qi²,

Wang³

2022

J Thorac Dis

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Background: Pulmonary nodular mucinous adenocarcinoma (PNMA) tends to be easily misdiagnosed as tuberculoma in practice. In this study, we aimed to discriminate PNMA from tuberculoma with dynamic computed tomography (CT).Methods: In this study, 38 consecutive pathologically confirmed cases of PNMA and 23 cases of tuberculoma from January 2015 to December 2019 were retrospectively collected. The mean CT attenuations of each lesion were examined. The values on the plain scan, the venous scan, and the enhanced values (CT attenuation of lesion of venous scan minus that of the plain scan) were tested with an independent t-test pair-wisely. Receiver operating characteristic (ROC) curve analyses were performed to test the differential diagnosis values. The presence of satellite lesions was determined with the chi-square test. Results:The mean CT attenuation of tuberculoma shown on the plain scan was significantly higher than that of PNMA (35.15±16.00 vs. 24.00±12.67 HU; P<0.01). The enhanced value of tuberculoma on venous scan was significantly lower than that of PNMA (13.44±13.40 vs. 22.52±14.00 HU; P=0.02). The optimum CT attenuation of the plain scan and the enhanced value for differential diagnosis were 28.80 and 14.25 HU [area under the curve (AUC) =0.72, 95% confidence interval (CI): 0.58-0.86; and AUC =0.70, 95% CI: 0.59-0.84], with sensitivity (78.3% vs. 71.1%) and specificity (63.8% vs. 69.6%) respectively. The satellite lesions were more often observed in the tuberculoma group (P<0.01). Conclusions:The CT attenuation of the plain scan, the enhanced value after enhancement, and the presence of satellite lesions might be useful in differentiating PNMA from tuberculoma.

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Solitary Nodular Invasive Mucinous Adenocarcinoma of the Lung: Imaging Diagnosis Using the Morphologic-Metabolic Dissociation Sign

Cited by 13 publications

References 32 publications

Invasive Mucinous Adenocarcinoma of the Lung Presenting With Multiple Cavities

Invasive Mucinous Adenocarcinoma of the Lung Presenting With Multiple Cavities

CT Features of Stage IA Invasive Mucinous Adenocarcinoma of the Lung and Establishment of a Prediction Model

Differential diagnosis of pulmonary nodular mucinous adenocarcinoma and tuberculoma with dynamic CT: a retrospective study

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