Clinicopathological, radiological and bronchoscopic evaluation of suspected lung malignancy
Keywords:CT thorax, Fiberoptic bronchoscopy, Lung malignancy
Background: This study was conducted to evaluate the clinical, pathological and radiological profile of suspected lung malignancy and its correlation with bronchoscopic findings.
Methods: A hospital based prospective study was conducted in the department of pulmonary medicine on 74 patients who were suspected with lung malignancy, clinically or radiologically. Following a detailed clinical examination, chest x-ray and CECT thorax, patients were included in the study and were subjected to bronchoscopy. Based on the bronchoscopic findings BAL, TBNA, forceps biopsy and TBLB were performed.
Results: Out of 74 patients, most of them belonged to the age group of 51-65 years. Majority were males. Cough was the most common symptom. 51 patients had weight loss and 48 had associated reduced appetite. 50 (67.6%) were smokers. Out of them 43 (86%) were beedi smokers. In CT thorax, most common presentation was mass lesion followed by consolidation, nodules and interstial thickening. Right side was the most common side involved. Bronchoscopy revealed intraluminal growth as the most common finding and the most common pattern noted was fungating growth. Squamous cell carcinoma was the most common cell type noted in 9 (27.03%) followed by adenocarcinoma and small cell carcinoma. Squamous cell carcinoma presented more commonly as central mass with intraluminal growth and adenocarcinoma presented more commonly as peripheral lesions with extraluminal compression in bronchoscopy.
Conclusions: Elderly smokers with cough and loss of appetite with weight loss can be suspicious of lung malignancy. CT and bronchoscopy are essential for the diagnosis of lung malignancy.
Acharya V, Unnikrishnan B, Shenoy A, Holla R. Utility of various bronchoscopic modalities in lung cancer diagnosis. Asian Pacific J Cancer Prev: APJCP. 2017;18(7):1931.
McWilliams A, Lam B, Sutedja T. Early proximal lung cancer diagnosis and treatment. Euro Resp J. 2009;33(3):656-65.
Kitahara Y, Murakami Y, Nakai S, Hiramatsu T, Kishimoto Y, Nihashi F, et al. Endobronchial Small-cell Lung Cancer with Intraluminal Growth Pattern Showing" Finger-in-glove" Appearance. Int Med. 2020;59(5):701-4.
Kumar BS, Subrata C. Study of Lung Cancer in a rural Medical College in hilly area of West Bengal. Cough. 2018;174:71-90.
Hafez MR, Abo-Elkheir OI. Clinical, radiological, laboratory and bronchoscopic features characterizing each type of bronchogenic carcinoma. Int J Res Med Sci. 2017;5(12):5107-16
Mandal SK, Singh TT, Sharma TD, Amrithalingam V. Clinico-pathology of lung cancer in a regional cancer center in Northeastern India. Asian Pac J Cancer Prev. 2013;14(12):7277-81.
Sisodia JA, Solanki RN, Patel MM. A Retrospective analytical study of prospectively collected data of patients of Lung Carcinoma confirmed by Histologically carried out at BJ Medical College, Ahmedabad, Gujarat. Int J Res Med. 2014;3(2);84-7.
Sarfraz S, Gupta R, Bhardwaj S. Histopathological patterns of endobronchial. Int J Contemp Med Res. 2018;5(11):1-5.
Dhandapani S, Srinivasan A, Rajagopalan R, Chellamuthu S, Rajkumar A, Palaniswamy P. Clinicopathological profile of lung cancer patients in a teaching hospital in South India. J Cardio-Thor Med. 2016;4(2):440-3.
Kumar M, Sharma DK, Garg M, Jain P. Clinicopathological Profile of Lung Cancer– Changing Trends in India. Int J Res Med. 2016;5(2):57-62.
McWilliams A, Lam B, Sutedja T. Early proximal lung cancer diagnosis and treatment. Euro Resp J. 2009 Mar 1;33(3):656-65.
Gupta V, Bhardwaj S, Bhagat OK. Pattern of transbroncial lung biopsy-proven lung malignancies in tertiary care hospital in north India: a clinicopathological study. Int J Adv Med. 2016;3(4):804-7.
Mohan A, Garg A, Gupta A, Sahu S, Choudhari C, Vashistha V, Ansari A, Pandey R, Bhalla AS, Madan K, Hadda V. Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center. Lung India. 2020;37(3):190.
Furrukh M. Tobacco smoking and lung cancer: perception-changing facts. Sultan Qaboos Univ Med J. 2013;13(3):345.
CalwinDavidsingh S. Bronchogenic carcinoma: Clinical, Radiological and Pathological Correlation (Doctoral dissertation, Coimbatore Medical College, Coimbatore). 2009.