Abstract
A 77-year-old man presented to our hospital with a chief complaint of an abnormal shadow, 7 mm in size, in the left upper lobe of the lung, pointed out by chest low-dose CT screening during a medical health check-up in March 2012. It was not detected by the previous check-up 2 years ago. Thin-slice CT images showed that there was a pure ground-glass nodule (GGN), ovoid in shape, and 9 mm in the maximum diameter. The lung cancer lesion underwent wedge resection with video-assisted thoracic surgery in May 2012. The pathologic diagnosis was p-stage 0-adenocarcinoma in situ (AIS), according to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma, 2011. Although AIS shows non-invasive slow-growing type early lung cancer with only a lepidic growth pattern, there was fear of the underestimation of malignancy based on the findings of routine TSCT images and pathologic Hematoxylin-Eosin staining in this case, because of the tumor volume doubling time, 151 days, on CT images, and immunohistochemical analysis.
