Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Changyu ¹ , CAI Yixin ¹ , HAO Zhipeng ¹ , GAO Yi ¹ , ZENG Zhilin ² , ZHANG Ni ¹ ,  FU Xiangning ¹

1. Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R.China;
2. Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R.China;

Corresponding author：

FU Xiangning, Email: fuxn2006@aliyun.com

Keywords：

Ground glass opacity (GGO); 2019 novel coronavirus (SARS-CoV-2) pneumonia (COVID-19); early-stage lung carcinoma; CT image features

DOI：

10.7507/1007-4848.202002069

Video：

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Objective To investigate CT image features of ground glass opacity (GGO)-like 2019 novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) and early-stage lung carcinoma for control and therapy of this acute severe respiratory disease.Methods We retrospectively analyzed the clinical data of 71 GGO-like COVID-19 patients who received therapy in Tongji Hospital of Huazhong University of Science and Technology between January 17^th and February 13^th, 2020. These 71 GGO-like COVID-19 patients were as a COVID-19 group. And 80 GGO-like early-stage lung carcinoma patients who underwent resection were as a lung carcinoma group. Clinical features such as sex, age, symptoms including fever, cough, fatigue, myalgia and dyspnea, detailed exposure history, confirmatory test (SARS-CoV-2 quantitative RT-PCR) and pathologic diagnosis were analyzed.Results Significantly different symptoms and exposure history between the two groups were detected (P<0.001). More lesions (61 patients at percentage of 85.92%, P<0.001), relative peripheral locations (69 patients at percentage of 97.18%, P<0.001) and larger opacities (65 patients at percentage of 91.55%, P<0.001) were found in chest radiographs of GGO-like COVID-19 compared with GGO-like early-stage lung carcinoma. Similar features appeared in early-stage of COVID-19 and lung carcinoma, while pneumonia developed into more extensive and basal predominant lung consolidation. Coexistence of GGO-like COVID-19 and early-stage lung carcinoma might occur.Conclusion Considering these similar and unique features of GGO-like COVID-19 and early-stage lung carcinoma, it is necessary to understand short time re-examination of chest radiographs and other diagnostic methods of these two diseases. We believe that the findings reported here are important for diagnosis and control of COVID-19 in China.

Citation： LIU Changyu, CAI Yixin, HAO Zhipeng, GAO Yi, ZENG Zhilin, ZHANG Ni, FU Xiangning. Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(4): 376-380. doi: 10.7507/1007-4848.202002069 Copy

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1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30]. Lancet, 2020, 395(10223): 497-506.
2. 国家卫生健康委员会. 截至 2 月 15 日 24 时新型冠状病毒肺炎疫情最新情况. URL: http://www.nhc.gov.cn/xcs/yqfkdt/202002/4a1b1ec6c03548099de1c3aa935d04fd.shtml.
3. 国家卫生健康委员会.《新型冠状病毒感染的肺炎诊疗方案（试行第五版）》, 2020. URL: http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11815/202002/t20200223_213615.html.
4. Jeffrey PK. Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist [published online ahead of print, 2020 Feb 4]. Radiology, 2020. doi:10.1148/radiol.2020200241.
5. Song FG, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia [published online ahead of print, 2020 Feb 6]. Radiology, 2020. doi:10.1148/radiol.2020200274.
6. Ikeda K, Awai K, Mori T, et al. Differential diagnosis of ground-glass opacity nodules: CT number analysis by three-dimensional computerized quantification. Chest, 2007, 132(3): 984-990.
7. Chang B, Hwang JH, Choi YH, et al. Natural history of pure ground-glass opacity lung nodules detected by low-dose CT scan. Chest, 2013, 143(1): 172-178.
8. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [published online ahead of print, 2020 Feb 7]. JAMA, 2020. doi:10.1001/jama.2020.1585.
9. 陈蕾, 刘辉国, 刘威, 等. 2019 新型冠状病毒肺炎 29 例临床特征分析. 中华结核和呼吸杂志, 2020, 43: E005.
10. Lee HY, Lee KS. Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications. J Thorac Imaging, 2011, 26(2): 106-118.
11. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology, 2008, 246(3): 697-722.
12. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.

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Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma

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