Prognosis of Semisolid Nodules in Pulmonary Medicine: A Comprehensive Review

Prognosis of semisolid nodules?

Dear Dr.
Jian,
I have two questions I would like to ask you:
1.
Regarding malignant nodules, solid nodules generally have a poorer prognosis, while ground-glass opacities (GGO) have a better prognosis.
I would like to inquire about the prognosis of semi-solid nodules.
I found some domestic physicians mentioning that semi-solid nodules have a poorer prognosis, but I also came across foreign textbooks stating, "Both the semi-solid and ground-glass opacities (GGO) appear to be more likely malignant than solid nodules and have a better prognosis than solid nodular carcinomas." Could you please clarify this for me?
2.
The report describes a medial apical irregular nodular GGO with a very small slightly denser part solid center touching the medial apical pleura.
Could you please clarify whether this nodule is classified as GGO or a part solid nodule? Thank you!

A-Hsien, 40~49 year old female. Ask Date: 2016/01/19

Dr. Jian Shuntian reply Pulmonology

According to academic theory, lung cancer (adenocarcinoma) typically begins as ground-glass opacities (GGO), then progresses to semi-solid lesions, and finally to solid lesions.
If a lesion is benign, it usually presents as solid from the outset.
Therefore, statistically, GGOs and semi-solid lesions are more likely to be malignant, while solid lesions have a higher likelihood of being benign.
However, in the case of lung cancer, solid lesions are generally considered to be more advanced.
Based on your description, it should be classified as semi-solid, and following up with the recommendations for solid lesions may be safer.
Some studies have shown that the average doubling times for pure GGOs, semi-solid lesions, and solid lesions are 813, 457, and 149 days, respectively.
Thank you for your response, Jian Shun-Tian.

Reply Date: 2016/01/19

More Info

The prognosis of semisolid nodules in pulmonary medicine is a complex topic that requires careful consideration of various factors, including the characteristics of the nodules, patient history, and associated risk factors. Semisolid nodules, which are defined as having both solid and ground-glass components, can present a diagnostic challenge.
1. Prognosis of Semisolid Nodules: The prognosis of semisolid nodules is generally considered to be more favorable than that of solid nodules but less favorable than that of pure ground-glass opacities (GGOs). Studies have shown that semisolid nodules can be indicative of malignancy, particularly when they exhibit certain characteristics such as irregular borders or rapid growth. However, the presence of a ground-glass component may suggest a lower likelihood of aggressive behavior.
The distinction between solid and semisolid nodules is crucial in determining prognosis. Solid nodules are more likely to be malignant, while GGOs often represent pre-invasive lesions or less aggressive forms of cancer. Semisolid nodules, on the other hand, may represent a transitional state, and their management often involves close monitoring and possibly biopsy to ascertain their nature.
In clinical practice, the management of semisolid nodules typically involves a multidisciplinary approach, including pulmonologists, radiologists, and oncologists. The decision to pursue further imaging, biopsy, or surgical intervention is based on the size, growth rate, and imaging characteristics of the nodule, as well as the patient's overall health and risk factors.

2. Interpretation of the Report: Regarding the specific report of a "medial apical irregular nodular GGO with a very small slightly denser part solid center touching medial apical pleura," this description suggests that the nodule has both ground-glass and solid components. Therefore, it can be classified as a part-solid nodule. The presence of irregularity and the solid component raises concern for potential malignancy, and further evaluation is warranted.

In summary, semisolid nodules present a unique challenge in pulmonary medicine. While they may have a better prognosis than solid nodules, their potential for malignancy cannot be overlooked. Close monitoring and further diagnostic evaluation are essential to determine the appropriate management strategy. It is crucial for patients with such findings to have thorough discussions with their healthcare providers to understand the implications and next steps in their care.

Similar Q&A

Concerns About Lung Nodules: What You Need to Know

Hello, Director Huang. Thank you for your valuable time. I do not smoke and occasionally cook. During my health check in February, a pulmonary nodule was discovered, and the follow-up results this month are as follows: IMP: 1. Regressive change of cavitary lesion and the solid da...

Dr. Huang Yiwen reply Pulmonology
Dear Ms. Wu: The micronodule still requires careful monitoring; it is best to have another examination in six months. A size of 2mm is acceptable. Changhua Hospital cares about you.

Understanding Lung Nodules: Are They Mostly Benign or Malignant?

Hello, Doctor. Last month, I had a low-dose computed tomography (LDCT) scan, and the report indicated a 0.4 cm triangular nodule (solid white) in the right middle lung. I would like to understand whether this type of nodule is more likely to be benign or malignant. Thank you, Doc...

Dr. Chen Junwei reply Pulmonology
1. A pulmonary nodule does not equal lung cancer; many benign lesions present as pulmonary nodules, such as tuberculomas, granulomas, hamartomas, and inflammatory pseudotumors. Approximately 96.4% of pulmonary nodules are benign. 2. The lesion measures only 0.4 cm and is solid (w...

Understanding Lung Nodules: Key Questions and Follow-Up Recommendations

1. In the report, SRS stands for "Spiculated Radiographic Score," which is a measure used to assess the characteristics of pulmonary nodules, while IM stands for "Imaging Measurement," which refers to the size or density measurements of the nodules. The varyin...

Dr. Huang Yiwen reply Pulmonology
Dear Kai: The numbers you mentioned refer to the specific slice and image seen by the radiologist; they don't hold particular significance and are merely indicative of the location. The frequency of examinations depends on risk factors such as smoking history, family history...

Understanding Lung Nodules: What You Need to Know and Next Steps

Hello Doctor: My mother underwent a self-paid health examination at Kaohsiung Chang Gung Memorial Hospital two weeks ago. We received the examination report yesterday, which indicated that there is a pulmonary nodule in the lower left lung that requires follow-up examination. Alt...

Dr. Ke Zhengchang reply Pulmonology
There are many causes of pulmonary nodules, which can be benign or malignant. A computed tomography (CT) scan and other examinations are necessary to differentiate between them. If it is not possible to distinguish between benign and malignant nodules, surgical resection or biops...