The Multi-slice Spiral Computed Tomography (MSCT) Features of Thin-Walled Cystic Lung Cancer with Ground Glass Opacity

Background: Lung cancer is the leading cause of cancer-related mortality worldwide. Thin-walled cystic lung cancer with ground glas s opacity (GGO) is a type of lung carcinoma with specific computed tomography (CT) features. Objectives: To investigate the imaging features of multi-slice spiral computed tomography (MSCT) of GGO and to improve the imaging diagnosis of this type of lung cancer. Patients and Methods: The clinical data of 24 patients with pathologically confirmed thin-walled cystic lung cancer with GGO were retrospectively analyzed in this study. The imaging features of preoperative MSCT, including vascular convergence, burr signs, pleural depression signs, lobulation signs, thickness and uniformity of the cavity wall, partitive membranes, and position of the ground-glass cavity, were examined. The relationship between the imaging features and postoperative pathological findings of lung carcinoma were also explored. Results: Most of the lesions (75.0%) were located in the upper lobe of the lungs. The size range of the cavity was 5.8 - 28.1 mm, with a mean of 13.6 ± 7.2 mm. Fifteen patients (62.5%) had a cavity wall thickness < 2 mm, 6 (25.0%) patients had a cavity wall thickness in the range of 2 - 3 mm, and 3 (12.5%) patients had a cavity wall thickness of about 3 - 4 mm. A uniform cavity wall was found in 10 (41.7%) cases, while a non-uniform cavity wall was observed in 14 (58.3%) cases. Eleven patients showed pure GGO (45.8%), while 13 patients showed mixed GGO (54.2%). Besides, nine patients (37.5%) showed lobular signs, 12 (50.0%) patients showed spicule signs, and 6 (28.6%) patients showed vascular convergence signs. Twelve patients (50.0%) had signs of pleural indentation, while 14 (66.7%) patients showed thick or thin small blood vessel opacity or fine partitive membranes. Twenty-three patients were diagnosed with lung adenocarcinoma, while one patients was diagnosed with mixed adenosquamous carcinoma. Conclusion: Thin-walled cystic lung cancer with GGO is a rare clinical phenomenon. The imaging features of this type of lung cancer on MSCT are consistent with the characteristics of lung cancers.