The morphological changes of bronchovascular bundles within subsolid nodules on HRCT correlate with the new IASLC classification of adenocarcinoma

• Published in: Clinical radiology 2018-06, Vol.73 (6), p.542-548
• Main Authors: Liu, L., Wu, N., Tang, W., Xu, F., Zhou, L.-n., Ma, P.-q., Li, L., Liang, X.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma in Situ - diagnostic imaging; Adenocarcinoma in Situ - pathology; Adenocarcinoma of Lung - diagnostic imaging; Adenocarcinoma of Lung - pathology; Adult; Aged; Blood Vessels - diagnostic imaging; Bronchi - blood supply; Bronchi - diagnostic imaging; Female; Humans; Hyperplasia - diagnostic imaging; Hyperplasia - pathology; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Male; Middle Aged; Multiple Pulmonary Nodules - diagnostic imaging; Multiple Pulmonary Nodules - pathology; Observer Variation; Retrospective Studies; Tomography, X-Ray Computed - methods
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2017.12.009

To observe the morphological changes of bronchovascular bundles within subsolid nodules on high-resolution (HR) computed tomography (CT) and analyse the correlation with the new adenocarcinoma classification. Two hundred and sixteen lesions (absent consolidation on mediastinal window) were reviewed retrospectively. CT features including dimensions, contour, morphological changes of the blood vessels, and bronchi/bronchioles, vacuole signs, and their correlation with histopathology were evaluated. Excluding nine non-cancerous lesions, 34 pre-invasive lesions (PILs) including 15 atypical adenomatous hyperplasias (AAHs) and 19 adenocarcinomas in situ (AISs), 21 minimally invasive adenocarcinomas (MIAs), and 152 invasive adenocarcinomas (IACs) were analysed. Lepidic, acinar, and papillary patterns were identified in this cohort of adenocarcinomas. IACs were grouped into three types: type I (lepidic pattern ≥80%, n=47), type II (lepidic pattern ≥50%,