Prevalence of Benign Pulmonary Lesions Excised for Suspicion of Malignancy: Could It Reflect a Quality Management Index of Indeterminate Lung Lesions?

Abstract

BackgroundThe effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery.MethodsWe retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup.ResultsOf the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion.ConclusionOur study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.

The value of the air bronchogram sign on CT image in the identification of different solitary pulmonary consolidation lesions

“…[11] Although the CT examination is indispensable for the detection or exclusion of intrapulmonary lesions, as well as the location, size and extension of SPLs, SPLs can seldom be diagnosed by CT image alone. [12] Unless fairly conclusive evidence is obtained from medical history, physical examination, laboratory studies, endoscopy, fluoroscopy, and/or angiocardiography, exploratory thoracotomy is necessary for diagnosis except unusual conditions. [12]…”

“…[12] Unless fairly conclusive evidence is obtained from medical history, physical examination, laboratory studies, endoscopy, fluoroscopy, and/or angiocardiography, exploratory thoracotomy is necessary for diagnosis except unusual conditions. [12]…”

Assessment of the cancer risk factors of solitary pulmonary nodules

“…The guidelines also recommend that individuals with nodules larger than 8 mm undergo a diagnostic work-up consisting of more invasive diagnostic procedures [ 4 , 6 – 8 ]. Devising effective strategies for managing patients with SPNs depends critically on the pre-test probability of malignancy [ 9 ]. However, there are no large samples or exact prediction models for assessing the cancer risk factors of SPNs, especially in the Chinese population.…”

Radiological and Pathological Correlation of Lung Nodules in a Background of Metastatic Disease

“…These advances in radiological techniques allow the detection of small indeterminate nodules that would otherwise have not been possible with the use of plain X-ray technique, thus increasing the likelihood of a CT detected nodule to be malignant. [7][8][9] To address the challenging question that CT detected lung nodule is more likely to be malignant, the medical records and relevant CT scans of children and adults who had been referred to our institution for the evaluation of indeterminate lung nodules and lung metastasis were reviewed. The patients' clinical or radiographic characteristics were correlated with histologic features of nodules and disease stage.…”