Abstract
A 64-year-old female was found to have localized ground-glass opacity (GGO) in the middle lobe on a chest computed tomography (CT) for screening. Middle lobectomy with video-assisted thoracoscopic surgery (VATS) was undertaken, and pathological diagnosis was a bronchioloalveolar carcinoma (BAC) in stage IA. A follow-up CT a year following the surgery revealed localized GGO in area S6 of the left lung. However, it disappeared during the gravitation-dependent gradient in the observation period. The patient was scanned again under prone position to exclude the gravitational effect, resulting in definite detection of the GGO. Left extended S6 segmentectomy with VATS was performed, and pathological diagnosis was a BAC in stage IA. As GGO existing in a gravitation-dependent area may be masked by the gravitation-dependent density, a change of the scanning position may lead to a proper detection of the tumor for the diagnosis of BAC.
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Millar AB, Denison DM. Vertical gradients of lung density in healthy supine men. Thorax 1989; 44: 485–90.
Verschakelen JA, Van fraeyenhoven L, Laureys G, Demedts M, Baert AL. Differences in CT density between dependent and nondependent portions of the lung: Influence of lung volume. AJR Am J Roentgenol 1993; 161: 713–7.
Noguchi M, Shimosato Y. The development and progression of adenocarcinoma of the lung. In: Hansen HH, ed. Lung Cancer V. Boston: Kluwer Academic, 1994; 131–42.
Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer 1995; 75: 2844–52.
Sone S, Li F, Yang ZG, Takashima S, Maruyama Y, Hasegawa M, et al. Characteristics of small lung cancers invisible on conventional chest radiography and detected by population based screening using spiral CT. Br J Radiol 2000; 73: 137–45.
Kuriyama K, Tateishi R, Doi O, Kodama K, Tatsuta M, Matsuda M, et al. CT-pathologic correlation in small peripheral lung cancers. AJR Am J Roentgenol 1987; 149: 1139–43.
Koizumi N, Akita S, Sakai K, Oda J, Tsukada H, Usuda H, et al. Cloudy nodule on HRCT: A new clinico-radiologic entity of pulmonary adenocarcinoma. Radiat Med 1995; 13: 273–8.
Suzuki K, Asamura H, Kusumoto M, Kondo H, Tsuchiya R. “Early” peripheral lung cancer: Prognostic significance of ground glass opacity on thin-section computed tomographic scan. Ann Thorac Surg 2002; 74: 1635–9.
Bandoh S, Fujita J, Fukunaga Y, Tojo Y, Okamoto T, Huang CL, et al. Bronchioloalveolar carcinoma masked by gravity-dependent gradient on computed tomography. Intern Med 2002; 41: 487–90.
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Misao, T., Minamoto, K., Nakano, H. et al. Effect of gravitation for detection of bronchioloalveolar carcinoma on computed tomography. Jpn J Thorac Caridovasc Surg 53, 309–312 (2005). https://doi.org/10.1007/s11748-005-0134-3
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DOI: https://doi.org/10.1007/s11748-005-0134-3