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Quantification of Ground-Glass Opacity on High-Resolution CT of Small Peripheral Adenocarcinoma of the Lung

Pathologic and Prognostic Implications

Eun A. Kim1, Takeshi Johkoh2, Kyung Soo Lee1, Joungho Han3, Kiminori Fujimoto4, Junko Sadohara4, Po Song Yang1, Takenori Kozuka2, Osamu Honda2 and Seonwoo Kim5

1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
2 Department of Radiology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
3 Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
4 Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan.
5 Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.



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Fig. 1A. Noguchi [4] type A adenocarcinoma of lung in 63-year-old woman. High-resolution (1-mm collimation) CT scan obtained at level of right upper lobar bronchus shows 12-mm nodule in right upper lobe. Both observers estimated extent of ground-glass opacity as 100%.

 


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Fig. 1B. Noguchi [4] type A adenocarcinoma of lung in 63-year-old woman. Photomicrograph of surgical specimen shows tumor cells growing along alveolar walls (so-called lepidic growth) (arrows). Alveolar walls are mildly thickened. (H and E, x 40)

 


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Fig. 2A. Noguchi [4] type B adenocarcinoma of lung in 48-year-old man. High-resolution (1-mm collimation) CT scan obtained at level of aortic arch shows 20-mm nodule in left upper lobe. Average extent of ground-glass opacity estimated by two observers was 80%.

 


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Fig. 2B. Noguchi [4] type B adenocarcinoma of lung in 48-year-old man. Photomicrograph of surgical specimen shows thickening of alveolar walls with tumor cell replacement. Note foci of alveolar collapse (arrows). (H and E, x 40)

 


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Fig. 3A. Noguchi [4] type C adenocarcinoma of lung in 43-year-old woman. High-resolution (1-mm collimation) CT scan obtained at level of right basal trunk shows 22-mm nodule in right middle lobe. Average extent of ground-glass opacity estimated by two observers was 45%.

 


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Fig. 3B. Noguchi [4] type C adenocarcinoma of lung in 43-year-old woman. Photomicrograph of surgical specimen shows tumor consisting of foci of lepidic growth (arrows) and fibrosis and alveolar collapse (open arrows). (H and E, x 40)

 


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Fig. 4A. Noguchi [4] type D adenocarcinoma of lung in 62-year-old woman. High-resolution (1-mm collimation) CT scan obtained at subaortic level shows 21-mm nodule in left upper lobe. Both observers estimated extent of ground-glass opacity as zero.

 


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Fig. 4B. Noguchi [4] type D adenocarcinoma of lung in 62-year-old woman. Photomicrograph of surgical specimen shows solid tumor of poorly differentiated adenocarcinoma with well-defined margin (arrows). (H and E, x 40)

 

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