Ground glass nodules with 5 years’ stability can grow after 10-year follow-up: do genetic features determine the fate?

Ground-glass nodules (GGNs) in the lung are lesions that appear hazy on computed tomography (CT), without obscuring underlying bronchial structures or pulmonary vessels. Both benign lesions including inflammation, hemorrhage, or focal interstitial fibrosis, and malignancies can present as GGNs. Slow-growing or stable GGNs indicate the presence of early stage lung cancers or preinvasive lesions, such as atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS) (1); these, along with lepidic predominant lung adenocarcinomas, grow along alveolar structures, maintain the air space and thus appear as GGNs on CT. GGNs are categorized into pure GGNs without solid components and part solid GGNs with solid components. AAH and AIS typically present as pure GGNs, whereas minimally invasive adenocarcinoma (MIA) and lepidic invasive adenocarcinoma are found as part solid GGNs, because their pathologically invasive parts appear solid on CT