Figure 9a: Transverse 1-mm CT sections through the right lower lobe. (a) A well-defined 6-mm ground-glass nodule (arrow) can be seen. (b) Image obtained more than 2 years after a shows a subtle increase in the size of the nodule (arrow). This finding was confirmed by noting the slightly altered relationship to adjacent vascular structures. Such subtle progression can be detected only by using 1-mm contiguous sections. Findings are consistent with adenocarcinoma in situ or minimally invasive adenocarcinoma, and continued yearly follow-up is recommended.
 Figure 9b: Transverse 1-mm CT sections through the right lower lobe. (a) A well-defined 6-mm ground-glass nodule (arrow) can be seen. (b) Image obtained more than 2 years after a shows a subtle increase in the size of the nodule (arrow). This finding was confirmed by noting the slightly altered relationship to adjacent vascular structures. Such subtle progression can be detected only by using 1-mm contiguous sections. Findings are consistent with adenocarcinoma in situ or minimally invasive adenocarcinoma, and continued yearly follow-up is recommended.  Figure 10a: (a) A 1-mm transverse CT image through the right midlung shows a 10-mm pure ground-glass nodule (arrow). (b) CT image in the same location as a at 15-month follow-up shows only a very subtle increase in opacity. (c) CT image in the same location as a and b a further 10 months after b shows the nodule has evolved into a larger part-solid nodule. Surgical resection revealed stage 1A invasive lepidic predominant adenocarcinoma.  Figure 10b: (a) A 1-mm transverse CT image through the right midlung shows a 10-mm pure ground-glass nodule (arrow). (b) CT image in the same location as a at 15-month follow-up shows only a very subtle increase in opacity. (c) CT image in the same location as a and b a further 10 months after b shows the nodule has evolved into a larger part-solid nodule. Surgical resection revealed stage 1A invasive lepidic predominant adenocarcinoma. |