There are glass nodules on the lungs

When breathing feels uncomfortable, or when you always have a bad cough, many people will be asked to do a CT scan when they go to the hospital for a check-up. At this time, some people will have glass nodules in their lungs. Some are benign and do not require treatment, but some are malignant and require immediate treatment. The presence of glass nodules in the lungs is mostly related to inflammation, and most people will recover after a period of treatment. In short, as long as a nodule is found, it must be treated thoroughly.

What are ground glass nodules?

Ground-glass nodule is a special term used to describe a type of nodular shadow in thin-layer CT images of the lungs. It refers to focal nodular shadows with increased density in the lungs, with clear or unclear boundaries. Moreover, the density of the lesion is not enough to cover the bronchovascular bundles running through it. This typical sign is called ground-glass nodule (GGN). It's like having a small piece of ground glass covering the lung tissue. At the same time, depending on whether it contains solid components, it can be divided into pure ground glass nodules and partial solid nodules.

Under what circumstances do ground glass nodules appear?

Generally speaking, both benign and malignant lesions in the lungs can sometimes appear as ground-glass nodules on thin-layer CT images of the lungs. Common causes may be inflammation, hemorrhage, and adenomatous hyperplasia. Of course, it may also be early lung cancer, including carcinoma in situ and microinvasive carcinoma.

When patients consult their doctors with imaging reports of ground-glass nodules in their lungs, doctors often recommend that patients follow up for reexaminations over a longer period of time rather than concluding whether the lesion is benign or malignant based on the results of a single examination. In other words, the appearance of ground-glass nodules in the lungs does not necessarily mean that one has lung cancer. Therefore, patients do not need to be frightened, anxious, or at a loss when talking about ground-glass nodules.

What kind of ground glass nodules may indicate lung cancer?

Generally speaking, lesions that grow diffusely, have unclear margins, are mainly characterized by pure ground-glass opacity, and disappear after a short period of follow-up are mostly benign lesions; lesions characterized by focal growth, clear margins, and accompanied by obvious lobulation, cavitation, pleural indentation signs, or obvious solid components within the lesions often indicate malignancy.

What should be done if ground-glass nodules are found in the lungs?

First of all, don’t panic. Even if it is early lung cancer that manifests as ground glass nodules, its growth is inert and its doubling time is long, generally 3-5 years, which means we have enough time to treat it.

Secondly, the treatment should be carried out according to the doctor's instructions. Your doctor will provide you with reasonable advice based on the characteristics of the ground glass nodule lesions, including follow-up, puncture biopsy, or surgery. In 2011, the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society jointly published the international multidisciplinary classification standards for lung adenocarcinoma, which established corresponding recommended guidelines for the treatment of ground-glass nodules. Generally speaking, isolated pure ground glass nodules with a diameter less than or equal to 5 mm do not require CT follow-up examinations. For isolated pure ground glass nodules with a diameter greater than 5 mm, a reexamination should be performed three months after discovery to determine whether the lesion still exists. If the lesion is still there and has not changed, a CT follow-up examination should be performed every year for at least three years. For isolated partially solid nodules, a follow-up examination should be conducted three months after the initial discovery to determine whether the lesion is still present. If it is still present and the internal solid component is less than 5 mm, annual follow-up examinations are recommended for at least three years. If the lesion persists and its internal solid component is greater than or equal to 5 mm, biopsy or surgical treatment is recommended.

In addition, it is important to remind you that because ground glass nodules are light in density and small in size, the image quality of chest CT is very high and they must be detected through high-resolution thin-layer scanning. In addition, during the review, attention must be paid to the matching of scanning conditions and positions so that images from different dates can be comparable. Therefore, it is recommended to choose a hospital with good CT image quality for examination, and try to choose the initial diagnosis hospital for re-examination, so as to facilitate the comparison of lesions.

All in all, ground-glass nodules in the lungs are not scary. Those lesions that have disappeared after three months of follow-up are all benign lesions. If they are persistent or focal lesions, you should be more careful. If the lesion is particularly small, only follow-up examination is needed. If the lesion becomes larger and solid during the examination, there is no need to be too nervous. Even if it is a malignant tumor, most of them are early lung cancer and can be removed surgically in time. Currently, most lesions can be cured by minimally invasive surgery. If the postoperative pathological diagnosis is early-stage lung cancer, there is no need for radiotherapy and chemotherapy.