242 Chapter 16 Table 2. Radiologic of the 2 completely histologically examined cases* as well as the 7 possible non-invasive cases from the pT3N0 cohort and matched invasive controls. (continued) Case Histology invasive yes/no Type of images Diameter Tumor (cm) GGO yes/no GGO Diameter (cm) Solid Diameter (cm) Radiologic Invasive yes/no Radiologic remarks 7 yes PET-CT 14.7 yes 14.1 10.8 yes Pneumonic type + solid mass surrounding GGO 8 yes CT-aorta 12.3 yes 12.3 11.1 yes Solid and consolidations 9 yes PET-CT 10.4 no n/a 10.4 yes Pneumonic type and solid 10 yes not available n/a n/a n/a n/a n/a n/a 11 yes CT-thorax 13.6 no n/a 13.6 yes Mainly solid 12 yes CT-thorax > 7 cm no n/a > 7 cm yes Solid mass 13 yes CT-thorax 10.1 yes 9.3 10.1 yes Mainly solid 14 yes PET-CT 9.1 no n/a 9.1 yes Solid mass 15 yes CT-thorax 8.0 no n/a 5.9 yes Solid mass GGO= Ground glass opacity; n/a = not applicable; n/m = not mentioned The retrieved preoperative imaging had varying imaging protocols, and consisted in 5 cases of a chest CT with relative thick image slides (3-5 mm), consistent with standard imaging quality in the study period. In 8 cases a PET-CT scan was retrieved, with unenhanced thick slice CT imaging available. Of 1 case a CT-Angiography (CTA) of the aorta was retrieved. In all 3 histologically non-invasive cases, radiology showed a pneumonia-like tumor morphology with multiple subsolid nodules. In 2 of 3 histologic non-invasive cases, the tumor occupied nearly the whole lobe, with diameters larger than 15 cm on CT-imaging. The lepidic predominant but focal micropapillary case, also showed a pneumonialike tumor morphology. Surprisingly, one of the control cases with invasive tumor (case 7) also showed a pneumonia-like tumor morphology. However, after pathological revision, this control case showed, beside distinct invasion, large areas with lepidic growth pattern, explaining the imaging appearance. The 2 papillary carcinoma cases showed a solid mass on CT imaging (Figure 2F). The other invasive control cases also showed a predominantly solid tumor morphology.
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