Ground-glass opacities (GGO) are gray areas that computed tomography scans or X-rays of the lungs pick up. The normal lungs appear black in such scans. GGOs can be seen mostly in patients with moderate to severe respiratory conditions, such as infections, cancers, and inflammation.
Recently, ground-glass opacities were seen in most patients infected with COVID-19. They helped classify the lung involvement in these cases.
Ground-glass opacities are usually benign and resolve spontaneously without any complications in patients with short-term illnesses. Most of these patients may not even know that it is present. Others may complain of cough, tiredness, and shortness of breath.
The presence of GGOs in chest scans could indicate:
- Fluid, pus, or cells in air sacs
- Thickening of walls of air sacs
- Interstitial thickening (thickening of lung tissue)
- Pulmonary edema
- Damage to blood vessels and hemorrhage
- Cancerous growths
What do ground-glass opacities indicate?
Ground-glass opacities (GGO) can be different in size, shape, intensity, arrangement, and pattern depending on the type of the condition and its severity.
Here are some types with examples of ground-glass opacities:
- Nodular: Ground-glass opacities appear as nodules and are seen in both cancerous and noncancerous conditions, such as:
- Pulmonary cryptococcus infection
- Focal interstitial fibrosis
- Pulmonary cryptococcus infection
- Occupational lung diseases
- Diffuse: Seen in multiple lobes where the lung tissue is replaced by fluid, inflammation, or damaged tissue
- Centrilobular: Seen in different lobules of the lung
- Linear: Indicates increased density in the lungs
- Desquamative interstitial pneumonia
- Nonspecific interstitial pneumonia
- Crazy paving: Crazy pattern seen in spaces between the lobules
- Acute eosinophilic pneumonia
- Halo: The affected area is present around the nodules
- Simple pulmonary eosinophilia
- Acute eosinophilic pneumonia
- Idiopathic hypereosinophilic syndrome
- Focal: Hazy areas in the lungs, either nonsolid or partially solid nodules
- Drug toxicity
- Usual interstitial pneumonia
- Atypical adenomatous hyperplasia
- Adenocarcinoma of the lung
What are the clinical symptoms of ground-glass opacity?
Ground-glass opacities (GGO) are confirmed with a computed tomography scan. The clinical symptoms of GGOs may slightly vary depending on the type and severity of the respiratory disease.
The clinical symptoms of GGOs may include:
- Shortness of breath
- Dyspnea (labored breathing)
- Orthopnea (shortness of breath when lying down)
- Sweating with fever and chills
- Severe fatigue and weakness
- Dry cough
- Coughing up yellow, green, or bloody mucus
- Chest pain
- Worsening of pain with cough or deep breaths
- Bluish discoloration or pale lips and nails
- Decreases appetite
- Weight loss
- Loss of taste and smell
- Throat pain
- Change in voice
- Musculoskeletal pain
- Nausea and vomiting
- Respiratory failure
How do you treat ground-glass opacities?
The treatment for ground-glass opacities (GGO) depends on the cause. Treating the cause may clear the lungs.
- In case of bacterial or viral infections, treating with intravenous antibiotics and other supportive medicine relieves the symptoms, and the haziness resolves spontaneously without any further management. In severe cases of ground-glass opacities, lobectomy surgery is used to remove the affected part of the lung.
- In conditions, such as autoimmune diseases, edema, or hemorrhage, the patient could be placed on oxygen support along with anti-inflammatory drugs or immunosuppressants, or steroids to reduce further damage to the blood vessels.
- Patients with cancer may undergo chemotherapy or radiotherapy or surgery depending on the severity and the type of cancer.
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Lee CT. What do we know about ground-glass opacity nodules in the lung? Transl Lung Cancer Res. 2015;4(5):656-659. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630533/
Science Direct. Ground Glass Opacity. https://www.sciencedirect.com/topics/medicine-and-dentistry/ground-glass-opacity
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