This article will discuss the diagnosis, treatment and pretreatment of pulmonary ground-glass disease.
In general, patients with ground-glass lung lesions smaller than 8 mm are not recommended for surgery. Even if pure ground-glass lesions are highly suspected to be carcinoma in situ or microinvasive carcinoma, immediate surgical treatment is not recommended for patients, and regular review is recommended. However, surgery can be considered if there are such risk factors :1. Enlargement of ground glass nodules; 2. There were more solid components of the nodules, mixed ground glass nodules, 3. There were cloud like changes beside the solid nodules, similar to satellite foci, 4. The lesion is irregularly shaped.
There are several points worth exploring for ground-glass pulmonary nodules, such as the application value of PET in these lesions? It is generally believed that PET is of little significance in the diagnosis of these nodules. However, high-resolution PET with respiratory gating is still worth exploring for these nodules. Secondly, the diagnostic significance of lung puncture biopsy in these nodules and its diagnostic status need to be further explored.
In terms of treatment, the current standard of treatment for these nodules is surgical treatment, including cuneiform resection, segmental resection, combined subsegmental resection, and even lobectomy. However, lobectomy should be taken with extreme caution in the treatment of undiagnosed ground glaucous nodules.
Other treatments, such as radiofrequency ablation, cryotherapy, and even radiotherapy, can be used as a supplement to the treatment of these lesions in cases where surgery is not suitable, but should not be the primary treatment.
The treatment effect of single pulmonary ground glass lesions is very good, even if the nodules are in situ lung carcinoma or small invasive lung carcinoma, there is basically no postoperative recurrence, and the long-term curative effect is excellent.
Orhan K Oz
Professor & Division Chief, Radiology
Charles and Jane Pak Center for Mineral Metabolism and Clinical Research
Division Chief of Nuclear Medicine.
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