Byline: Guoliang. Xue, Zhichao. Li, Gang. Wang, Zhigang. Wei, Xin. Ye
With the wide application of low-dose computed tomography (CT) and high-resolution CT, the increasing cases of pulmonary nodules are identified through routine thoracic imaging examination, many of which are presented as multiple ground-glass opacities (GGOs). The multiple GGOs could be divided into four pathological types and usually got different combined mutation patterns, suggesting that each GGO is an independent event and should be treated separately. However, there is no established guideline to the treatment of multiple GGOs so far. Here, we report a multiple GGOs case with a different mutation pattern treated by CT-guided percutaneous microwave ablation.
The rapid medical imaging development and broad application of high-resolution computed tomography (CT) increase pulmonary nodules identification through thoracic imaging examination. These nodules are multiple ground-glass opacities (GGOs) classified as pure GGOs (pGGOs), without solid components inside, and mixed GGOs (mGGOs) with pure GGO and consolidated regions. Two or more GGOs synchronously found in the same lobe, lung, or bilateral lungs, with multifocal origins rather than intrapulmonary metastasis, are multiple GGOs. They are divided into atypical adenomatous hyperplasia, adenocarcinoma in situ , microinvasive lung adenocarcinoma, and invasive adenocarcinoma. GGOs have different mutation patterns combined, suggesting separated treatments. No established guideline on multiple GGOs therapies exists. We report a multiple GGOs case with different mutation patterns treated by CT-guided percutaneous microwave ablation (MWA).
A nonsmoker 44-year-old male, with no family cancer records and ~15 years of contact with graphite powder and pulverized lime, was admitted to the hospital with short breath and anhelation for a week, with no headache, cough, or fever. Blood examination and tumor markers were negative. CT scan showed both lungs with multiple nodules and lesions on the inferior lobar portion. A 25 mm × 23 mm irregular mGGO with lobulation and spiculation signs was observed in the right inferior lobar [Figure 1]a with air bronchogram and pleural indentation. Two nodules were in the left inferior lobar: The...