Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions
Lung nodules are frequent findings in chest computed tomography (CT) in patients with metastatic melanoma. In this study, we assessed the frequency and compared morphologic differences of metastases and benign nodules. We retrospectively evaluated 85 patients with melanoma (AJCC stage III or IV). In...
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2021-05-01
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author | Simone Alexandra Stadelmann Christian Blüthgen Gianluca Milanese Thi Dan Linh Nguyen-Kim Julia-Tatjana Maul Reinhard Dummer Thomas Frauenfelder Matthias Eberhard |
author_facet | Simone Alexandra Stadelmann Christian Blüthgen Gianluca Milanese Thi Dan Linh Nguyen-Kim Julia-Tatjana Maul Reinhard Dummer Thomas Frauenfelder Matthias Eberhard |
author_sort | Simone Alexandra Stadelmann |
collection | DOAJ |
description | Lung nodules are frequent findings in chest computed tomography (CT) in patients with metastatic melanoma. In this study, we assessed the frequency and compared morphologic differences of metastases and benign nodules. We retrospectively evaluated 85 patients with melanoma (AJCC stage III or IV). Inclusion criteria were ≤20 lung nodules and follow-up using CT ≥183 days after baseline. Lung nodules were evaluated for size and morphology. Nodules with significant growth, nodule regression in line with RECIST assessment or histologic confirmation were judged to be metastases. A total of 438 lung nodules were evaluated, of which 68% were metastases. At least one metastasis was found in 78% of patients. A 10 mm diameter cut-off (used for RECIST) showed a specificity of 95% and a sensitivity of 20% for diagnosing metastases. Central location (<i>n</i> = 122) was more common in metastatic nodules (<i>p</i> = 0.009). Subsolid morphology (<i>n</i> = 53) was more frequent (<i>p</i> < 0.001), and calcifications (<i>n</i> = 13) were solely found in non-metastatic lung nodules (<i>p</i> < 0.001). Our data show that lung nodules are prevalent in about two-thirds of melanoma patients (AJCC stage III/IV) and the majority are metastases. Even though we found a few morphologic indicators for metastatic or non-metastatic lung nodules, morphology has limited value to predict the presence of lung metastases. |
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spelling | doaj.art-e73e70b0a7234695996913df78825eef2023-11-21T18:37:17ZengMDPI AGDiagnostics2075-44182021-05-0111583710.3390/diagnostics11050837Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic LesionsSimone Alexandra Stadelmann0Christian Blüthgen1Gianluca Milanese2Thi Dan Linh Nguyen-Kim3Julia-Tatjana Maul4Reinhard Dummer5Thomas Frauenfelder6Matthias Eberhard7Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandDepartment of Medicine and Surgery (DiMeC), University of Parma, 43126 Parma, ItalyInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandDepartment of Dermatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandDepartment of Dermatology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandLung nodules are frequent findings in chest computed tomography (CT) in patients with metastatic melanoma. In this study, we assessed the frequency and compared morphologic differences of metastases and benign nodules. We retrospectively evaluated 85 patients with melanoma (AJCC stage III or IV). Inclusion criteria were ≤20 lung nodules and follow-up using CT ≥183 days after baseline. Lung nodules were evaluated for size and morphology. Nodules with significant growth, nodule regression in line with RECIST assessment or histologic confirmation were judged to be metastases. A total of 438 lung nodules were evaluated, of which 68% were metastases. At least one metastasis was found in 78% of patients. A 10 mm diameter cut-off (used for RECIST) showed a specificity of 95% and a sensitivity of 20% for diagnosing metastases. Central location (<i>n</i> = 122) was more common in metastatic nodules (<i>p</i> = 0.009). Subsolid morphology (<i>n</i> = 53) was more frequent (<i>p</i> < 0.001), and calcifications (<i>n</i> = 13) were solely found in non-metastatic lung nodules (<i>p</i> < 0.001). Our data show that lung nodules are prevalent in about two-thirds of melanoma patients (AJCC stage III/IV) and the majority are metastases. Even though we found a few morphologic indicators for metastatic or non-metastatic lung nodules, morphology has limited value to predict the presence of lung metastases.https://www.mdpi.com/2075-4418/11/5/837pulmonary nodulesmalignant melanomamulti-detector computed tomography |
spellingShingle | Simone Alexandra Stadelmann Christian Blüthgen Gianluca Milanese Thi Dan Linh Nguyen-Kim Julia-Tatjana Maul Reinhard Dummer Thomas Frauenfelder Matthias Eberhard Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions Diagnostics pulmonary nodules malignant melanoma multi-detector computed tomography |
title | Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions |
title_full | Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions |
title_fullStr | Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions |
title_full_unstemmed | Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions |
title_short | Lung Nodules in Melanoma Patients: Morphologic Criteria to Differentiate Non-Metastatic and Metastatic Lesions |
title_sort | lung nodules in melanoma patients morphologic criteria to differentiate non metastatic and metastatic lesions |
topic | pulmonary nodules malignant melanoma multi-detector computed tomography |
url | https://www.mdpi.com/2075-4418/11/5/837 |
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