DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172086

Diagnosis and staging of lung carcinoma with CT scan and its histopathological correlation

Dhara Shah, Mona Shastri, Dhagash Patel, Nehal Diwanji, Ekta Desai, Mona Chitara, Avani Bhatt

Abstract


Background: Lung cancer is the most common cancer worldwide. Hence, timely diagnosis and accurate staging of the carcinoma is critical for the treatment and prognosis. So, this study was performed to evaluate the role of CT scan in diagnosis and staging of lung cancer.

Methods: This was a prospective and observational study carried out over one and half years at a tertiary care hospital. The patients found to have abnormalities on chest X-ray suggestive of carcinoma were included in the study. Pre and post contrast CT scans were performed. Individual patient biopsies were done for histopathological staging.

Results: Most patients belonged to 41-50 years age group with male preponderance (81.33%). Habit of smoking was prevalent among the lung cancer patients. Almost all masses (92%) showed heterogeneous contrast enhancement on CT. Additionally, there were calcifications, cavitation, hilar enlargement, pleural invasion, mediastinal lymphadenopathy and contiguous bone involvement. Adenocarcinoma was the most common (46.66%) form of cancer followed by squamous cell carcinoma (42.66%). For histopathological diagnosis, majority of patients (73.33%) were diagnosed using CT guided biopsy. In the remaining patients, USG guided biopsy or fibreoptic bronchoscopy were performed. The most common lobe affected by bronchogenic carcinoma was right upper lobe. The most common site of metastasis was pleura (22.66%) followed by bone (17.33%). Majority of the patients (41.33%) presented with TNM stage IV.

Conclusions: CT scan as a modality for detection and staging of bronchogenic carcinoma is superior to chest radiograph. CT guided FNAC has a high success rate in evaluation of lung carcinoma.

 


Keywords


Bronchogenic carcinoma, CT scan, CT guided biopsy, Histopathology, Tumor staging

Full Text:

PDF

References


Stewart BW. World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer. World Health Organization; 2014.

Alberg AB, Samet JM. Epidemiology of lung cancer. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed: Saunders Elsevier; 2016.

Biesalski HK, Bueno de Mesquita B, Chesson A, Chytil F, Grimble R, Hermus RJ, et al. European consensus statement on lung cancer: risk factors and prevention. Lung Cancer Panel. Cancer J Clinic. 1998;48(3):167-76.

Horn LL, Johnson DH. Chapter 107: Neoplasms of the lung. In Kasper, DL; Hauser, SL; Jameson, JL; Fauci, AS; Longo, DL; Loscalzo, J. Harrison's Principles of Internal Medicine (19th ed.). McGraw-Hill; 2015.

Behera D, Balamugesh T. Lung cancer in India. The Indian J Chest Dis Allied Sci. 2004;46(4):269-81.

Singh N, Aggarwal AN, Gupta D, Behera D, Jindal SK. Unchanging clinico-epidemiological profile of lung cancer in north India over three decades. Cancer Epidemiol. 2010;34(1):101-4.

Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, et al. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer. 2012;49(1):74-81.

Malik PS, Sharma MC, Mohanti BK, Shukla NK, Deo S, Mohan A, et al. Clinico-pathological profile of lung cancer at AIIMS: a changing paradigm in India. Asian Pacific J Cancer Prevent. 2013;14(1):489-94.

Woodring JH. Determining the cause of pulmonary atelectasis: a comparison of plain radiography and CT. Am J Roentgenol. 1988;150(4):757-63.

White CS, Romney BM, Mason AC, Austin JH, Miller BH, Protopapas Z. Primary carcinoma of the lung overlooked at CT: analysis of findings in 14 patients. Radiol. 1996;199(1):109-15.

Patz EF, Erasmus JJ, McAdams HP, Connolly JE, Marom EM, Goodman PC, et al. Lung cancer staging and management: comparison of contrast-enhanced and nonenhanced helical CT of the thorax. Radiol. 1999;212(1):56-60.

Pennes DR, Glazer GM, Wimbish KJ, Gross BH, Long RW, Orringer MB. Chest wall invasion by lung cancer: limitations of CT evaluation. Am J Roentgenol. 1985;144(3):507-11.

Kuriyama K, Tateishi R, Doi O, Higashiyama M, Kodama K, Inoue E, et al. Prevalence of air bronchograms in small peripheral carcinomas of the lung on thin-section CT: comparison with benign tumors. Am J Roentgenol. 1991;156(5):921-4.

Singh J, Garg L, Setia V. Computed tomography (Ct) guided transthoracic needle aspiration cytology in difficult thoracic mass lesions-not approachable by USG. Indian J Radiol Imaging. 2004;14(4):395-400.

Li H, Boiselle PM, Shepard JO, Trotman-Dickenson B, McLoud TC. Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules. Am J Roentgenol. 1996;167(1):105-9.

Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiol. 2003;229(2):475-81.

Laroche C, Fairbairn I, Moss H, Pepke-Zaba J, Sharples L, Flower C, et al. Role of computed tomographic scanning of the thorax prior to bronchoscopy in the investigation of suspected lung cancer. Thorax. 2000;55(5):359-63.

Garland LH. Bronchial carcinoma. Lobar distribution of lesions in 250 cases. California Med. 1961;94:7-8.

Quinn D, Gianlupi A, Broste S. The changing radiographic presentation of bronchogenic carcinoma with reference to cell types. Chest. 1996;110(6):1474-9.

Riihimaki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J, et al. Metastatic sites and survival in lung cancer. Lung Cancer. 2014;86(1):78-84.