The Clinical Approach to Nodular Ground Glass Opacity in the Lung

Abstract

The introduction of low dose chest computed tomography for health screening in Korea has resulted in increased detection of solitary pulmonary nodules, including nodular ground glass opacity. In contrast to the classic solitary pulmonary nodule, nodular ground glass opacity (GGO) has special characteristics especially in Koreans. More than half of nodular GGOs are transient and they are caused by a pulmonary infiltrate of eosinophils. However, persistent nodular GGO (nGGO) showed a high malignant potential such as atypical adenomatous hyperplasia and bronchioloalveolar cell carcinoma. The increasing use of video assisted thoracoscopic surgery (VATS) for diagnosis and treatment is the current trend for managing nodular GGO. Even though lobectomy is still the standard management for malignant nGGO, limited resection (wide wedge resection or segmentectomy) is widely used for the small malignant GGO (Noguchi types A and B). Multifocal nodular GGOs are mostly of a synchronous origin rather than intrapulmonary metastasis. Therefore, aggressive surgical resection is warranted. This review contains the current concepts for managing nodular GGO and it especially focuses on the Korean data. (J Lung Cancer 2010;9(1):1 󰠏 8)