PAN Gaojian 1 , GENG Guojun 2 , ZHU Xiaolei 2 , LIU Hongming 2 , LI Ning 2 , PAN Jianyun 1 , YE Guanzhi 2 , JIANG Jie 2
  • 1. Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, P. R. China;
  • 2. Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian, P. R. China;
YE Guanzhi, Email: ygz23230286@163.com; JIANG Jie, Email: jiangjie06@126.com
Suspected Malignant Pulmonary nodules; pathological characteristics; imaging features
10.7507/1007-4848.202312012
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Objective  To discuss the main pathological types and imaging features of pulmonary nodules highly suspected to be malignant in clinical practice but pathologically confirmed to be benign. Method  A retrospective analysis was conducted on the clinical data of the patients with pulmonary nodules, who were initially highly suspected of malignancy but were pathologically confirmed as benign, treated at the First Affiliated Hospital of Xiamen University from December 2020 to April 2023. Based on the results of preoperative discussions, the patients were divided into a benign group and a suspicious malignancy group. Results  Finally, 232 patients were collected, including 112 males and 120 females, with an average age of 51 years. There were 127 patients in the benign group, and 105 patients in the suspicious malignancy group. There was no statistical difference in age, gender, symptoms, smoking history, and tumor history between the two groups (P>0.05). However, there were statistical differences in nodule density, CT values, margins, shapes, andmalignant signs between the two groups (P<0.05). The analysis showed that in suspiciously malignant pulmonary nodules, the solid group was mainly characterized by collagen nodules and fibrous tissue hyperplasia (33.3%), tuberculosis (20.3%), and fungal infection (18.5%), while the non-solid group was primarily composed of collagen nodules and fibrous tissue hyperplasia (39.2%) and atypical adenomatous hyperplasia (17.6%). Conclusion The benign pulmonary nodules suspected of malignancy are pathologically characterized by the presence of collagen nodules and fibrous tissue hyperplasia, tuberculosis, atypical adenomatous hyperplasia, and fungal infections. In terms of imaging features, they typically present as non-solid nodules, accompanied by signs of malignancy such as spiculation, lobulation, cavitation, and pleural retraction.