Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis

<b>Background</b>: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. <b>Methods</b>: This is a single-center retrospective study. Fro...

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Main Authors: Chiara Catelli, Susanna Guerrini, Miriana D’Alessandro, Paolo Cameli, Antonio Fabiano, Giorgio Torrigiani, Cristiana Bellan, Maria Antonietta Mazzei, Piero Paladini, Luca Luzzi
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Language:English
Published: MDPI AG 2024-10-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/21/2389
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author Chiara Catelli
Susanna Guerrini
Miriana D’Alessandro
Paolo Cameli
Antonio Fabiano
Giorgio Torrigiani
Cristiana Bellan
Maria Antonietta Mazzei
Piero Paladini
Luca Luzzi
author_facet Chiara Catelli
Susanna Guerrini
Miriana D’Alessandro
Paolo Cameli
Antonio Fabiano
Giorgio Torrigiani
Cristiana Bellan
Maria Antonietta Mazzei
Piero Paladini
Luca Luzzi
author_sort Chiara Catelli
collection DOAJ
description <b>Background</b>: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. <b>Methods</b>: This is a single-center retrospective study. From 2010 to 2023, among 685 patients affected by pulmonary sarcoidosis, 23 patients developed pulmonary nodules of a suspicious malignant nature. The HRCT characteristics of biopsy-proven malignant (Group A) vs. inflammatory (Group B) nodules were analyzed and compared. <b>Results</b>: A significant difference was observed between the groups in terms of age (<i>p</i> = 0.012). With regard to HRCT features, statistical distinctions were observed in the appearance of the nodule, more frequently spiculated in the case of lung cancer (<i>p</i> < 0.01), in the diameter of the nodule (Group A: 23.5 mm; Group B: 12.18 mm, <i>p</i> < 0.02), in the median nodule density (Group A: 60.0 HU, Group B: −126.7 HU, <i>p</i> < 0.01), and in the number of pulmonary nodules, as a single parenchymal nodule was more frequently observed in the neoplastic patient group (<i>p</i> = 0.043). In Group A, the 18-PET-CT demonstrated hilar/mediastinal lymphadenopathy in 100% of cases; histology following surgery did not report any cases of malignant lymph node involvement. <b>Conclusions</b>: An accurate clinical evaluation and HRCT investigation are crucial for diagnosing lung cancer in patients with sarcoidosis in order to determine who requires surgical resection. The spiculated morphology of the nodule, greater size, the number of pulmonary nodules, and density using HRCT appear to correlate with the malignant nature of the lesion.
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spelling doaj-art-7964eb5de3ef4b4a91a13c7208c5b90f2024-11-08T14:34:46ZengMDPI AGDiagnostics2075-44182024-10-011421238910.3390/diagnostics14212389Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with SarcoidosisChiara Catelli0Susanna Guerrini1Miriana D’Alessandro2Paolo Cameli3Antonio Fabiano4Giorgio Torrigiani5Cristiana Bellan6Maria Antonietta Mazzei7Piero Paladini8Luca Luzzi9Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyDiagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyRespiratory Disease and Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Siena University, 53100 Siena, ItalyRespiratory Disease and Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Siena University, 53100 Siena, ItalyThoracic Surgery Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyDiagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyInstitute of Pathological Anatomy and Histology, Department of Medical Biotechnologies, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyDiagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyThoracic Surgery Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, ItalyLung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy<b>Background</b>: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. <b>Methods</b>: This is a single-center retrospective study. From 2010 to 2023, among 685 patients affected by pulmonary sarcoidosis, 23 patients developed pulmonary nodules of a suspicious malignant nature. The HRCT characteristics of biopsy-proven malignant (Group A) vs. inflammatory (Group B) nodules were analyzed and compared. <b>Results</b>: A significant difference was observed between the groups in terms of age (<i>p</i> = 0.012). With regard to HRCT features, statistical distinctions were observed in the appearance of the nodule, more frequently spiculated in the case of lung cancer (<i>p</i> < 0.01), in the diameter of the nodule (Group A: 23.5 mm; Group B: 12.18 mm, <i>p</i> < 0.02), in the median nodule density (Group A: 60.0 HU, Group B: −126.7 HU, <i>p</i> < 0.01), and in the number of pulmonary nodules, as a single parenchymal nodule was more frequently observed in the neoplastic patient group (<i>p</i> = 0.043). In Group A, the 18-PET-CT demonstrated hilar/mediastinal lymphadenopathy in 100% of cases; histology following surgery did not report any cases of malignant lymph node involvement. <b>Conclusions</b>: An accurate clinical evaluation and HRCT investigation are crucial for diagnosing lung cancer in patients with sarcoidosis in order to determine who requires surgical resection. The spiculated morphology of the nodule, greater size, the number of pulmonary nodules, and density using HRCT appear to correlate with the malignant nature of the lesion.https://www.mdpi.com/2075-4418/14/21/2389lung nodulepulmonary sarcoidosislung cancerlung adenocarcinomacomputed tomographylymph nodes
spellingShingle Chiara Catelli
Susanna Guerrini
Miriana D’Alessandro
Paolo Cameli
Antonio Fabiano
Giorgio Torrigiani
Cristiana Bellan
Maria Antonietta Mazzei
Piero Paladini
Luca Luzzi
Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
Diagnostics
lung nodule
pulmonary sarcoidosis
lung cancer
lung adenocarcinoma
computed tomography
lymph nodes
title Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
title_full Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
title_fullStr Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
title_full_unstemmed Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
title_short Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
title_sort sarcoid nodule or lung cancer a high resolution computed tomography based retrospective study of pulmonary nodules in patients with sarcoidosis
topic lung nodule
pulmonary sarcoidosis
lung cancer
lung adenocarcinoma
computed tomography
lymph nodes
url https://www.mdpi.com/2075-4418/14/21/2389
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