Correlations between tumor stroma characters and dynamic enhanced MDCT findings in nodular pulmonary adenocarcinoma.

OBJECTIVE: This study aimed to evaluate correlations between tumor stroma characters and dynamic contrast-enhanced computed tomographic (CT) findings in nodular pulmonary adenocarcinoma. METHODS: Thirty-three patients with nodular pulmonary adenocarcinoma underwent dynamic contrast-enhancement CT scan before surgery. CT findings include wash-in, wash-out, and distribution of enhancement. The proportion of invasive and noninvasive stroma in tumor was calculated. RESULTS: Invasive and noninvasive stroma proportion in tumor was correlated positively with wash-in and wash-out enhancement, respectively. CONCLUSIONS: Tumor stroma proliferation may explain the pathologic basis of CT dynamic enhancement and be a useful prognostic factor of pulmonary adenocarcinoma.

Relationship between peripheral lung cancer and the surrounding bronchi, pulmonary arteries, pulmonary veins: a multidetector CT observation.

AIM: This study aimed to investigate the relationship between peripheral lung cancer and the surrounding pulmonary vessels and bronchi using contrast-enhanced multidetector computed tomography (MDCT) and to analyze associated factors such as pathology types, stage, size, density, and location of peripheral lung cancer. MATERIALS AND METHODS: A total of 93 patients with solitary peripheral lung cancers underwent contrast-enhanced MDCT before thoracotomy were enrolled. Multiplanar reconstruction, maximal intensity projection, and volume rendering were used for demonstrating the patterns of the tumor-bronchi (Br), tumor-pulmonary artery (PA) and tumor-pulmonary vein (PV) relationship, respectively. Five subtypes were identified: Type1 (Br1, PA1 and PV1), Br, PA, or PV was erupted at the edge of nodule; Type2 (Br2, PA2, and PV2), erupted at the center of nodule; Type3 (Br3, PA3 and PV3), penetrated through the nodule; Type4, (Br4, PA4 and PV4), contacting the nodule but stretched or encased; Type5 (Br5, PA5, and PV5), contacting the nodule but smoothly compressed. RESULTS: Both bronchi and PA were interrupted in 70 (Type 1+2); both narrowed in 9 (Type 3+4). The bronchi and PA changes surrounding the lung cancer had positive relations (χ(2)=12.3918, r=0.7524, P<.01). Br1 and PA1 were more often seen in the group of solid, ≥2.0 cm, and Stage II-IV focal lesions, while Br2 and PA2, more often in the group of part-solid, non-solid, <2.0 cm, and Stage I focal lesions. PV2 was more often seen in the part-solid and non-solid focal lesions group, while PV (4+5), more often in solid focal lesions group. CONCLUSION: MDCT can demonstrate and subtype relationships among peripheral lung cancer and the bronchi, pulmonary arteries and pulmonary veins. This can be the basis for further clinical research and differential diagnosis.

[Correlation of early phase contrast enhancement of multi-detector row computed tomography to tumor stroma of nodular solid lung adenocarcinoma].

BACKGROUND & OBJECTIVE: Dynamic enhanced multi-detector row CT (MDCT) has been used in differential diagnosis of pulmonary nodules, but its mechanism was unclear yet. This study was to evaluate the correlations of early phase enhancement of MDCT to proportion and distribution of stroma in solid lung adenocarcinoma. METHODS: A total of 31 patients with lung adenocarcinoma underwent routine contrast-enhanced MDCT. All lesions were solid solitary pulmonary nodules confirmed by pathology. CT observation items included net enhancement and distribution of enhancement. Tumor morphology was observed with HE staining. About 25 fields of view of each specimen at low magnification were scanned to obtain digital data. Semi-auto segmentation software was used to calculate mean stroma proportion. RESULTS: The proportion of invasive stroma in tumors was correlated positively to CT enhancement value (r=0.483, P=0.006). Of the 31 nodules, 18 (58.1%) showed homogenous enhancement, 10 (32.3%) showed peripheral inhomogenous enhancement, 1 (3.2%) showed central inhomogenous enhancement, 1 (3.2%) showed asymmetrical inhomogenous enhancement, 1 (3.2%) showed no enhancement; 18 (58.1%) nodules showed mixed distribution of stroma, 11 (35.5%) showed peripheral distribution, 1 (3.2%) showed central distribution, 1 (3.2%) showed asymmetrical distribution. Most acinar adenocarcinomas had net enhancement of > 20 Hu, which was significantly higher than that of solid adenocarcinomas with mucin subtype (P=0.005). CONCLUSIONS: Extent and pattern of CT enhancement of solid lung adenocarcinoma nodules reflect the proliferation and distribution of stroma, respectively. It is helpful to comprehend some false negative on CT enhancement by adequately understanding of the pathologic features of different subtypes of lung adenocarcinoma.