Role of multidetector computed tomography in evaluation of suspected bronchogenic carcinoma

Abstract

INTRODUCTIONBronchogenic carcinoma was considered to be rare in the beginning of the century but has now reached epidemic proportions. This dramatic increase correlates with the widespread prevalence of cigarette smoking.1 Lung cancer is the leading cause of cancer mortality for both men and women, responsible for more deaths than prostate, breast, and colorectal cancers combined.2 Physical symptoms such as fever, cough, expectoration, haemoptysis, weight loss and anorexia are common to lung cancer. However, age of the patient, smoking history, mediastinal symptoms such as hoarseness of voice, SVC obstruction and dysphagia favours the diagnosis of lung cancer. On examination, there may be signs of collapse or mass, clubbing and metastatic and non-metastatic complications of lung cancer. 1 WHO classified bronchogenic carcinoma into four major cell types which makes up 88% of all primary lung neoplasm. These are squamous or epidermoid carcinoma, ABSTRACT Background: Bronchogenic carcinoma is the leading cause of cancer deaths in developed countries and is rising at alarming rates in developing countries. Deaths due to lung cancer are more than those due to colorectal, breast and prostate cancers put together. CT remains the routine imaging procedure for determining resectability and assessing intra-and extra thoracic spread of lung cancer. Methods: 30 patients with strong clinical / radiological suspicious of bronchogenic carcinoma were included in this study. MDCT was carried out and its provisional diagnosis of bronchogenic carcinoma was correlated with pathological diagnosis obtained on bronchoscopic biopsy / CT guided FNAC. Results: Patient's age ranged between 45 to 80 years with the mean age of 59 years. There was significant male preponderance (26 males) with smoking being the most common risk factor (83.3%). Cough (83.3%) and dyspnea (80%) were the commonest symptoms. The most common radiological manifestation was central hilar mass seen in 20 (66.6%) patients and peripheral mass seen in 10 (33.3%) patients. Provisional CT diagnosis was found in complete correlation with pathological diagnosis made on bronchoscopy biopsy/ CT guided FNAC in 28 (93.3%) patients and others 2 patients diagnosed as pulmonary tuberculosis, non caseating granulomatous inflammation on histopathological diagnosis. Squamous cell carcinoma was the commonest histopathological type seen in 16 (53.3%) patients followed by adenocarcinoma seen in 8 (26.6%) patients. Conclusions: Multidetector computed tomography plays an important role in evaluating and staging of bronchogenic carcinoma.CT had the high predictive value in evaluating bronchogenic carcinoma and found to be 93.3%.

Staging of Bronchogenic Carcinoma at Tertiary Health Care Centre with Multidetector Computed Tomography and Histopathological Correlation

“…This is in concordance with the study by Malik PS et al 6 (2013), Krishnamurthy A et al 12 (2012), Shad D et al 7 (2017), Dr. Modi M et al 19 (2016) and Dr. Babu S et al 5 (2016) which showed an increasing trend in the incidence of adenocarcinoma. However, our findings are contrary to the studies done by Dr. Adaikkalavan et al 18 (2017), Rawat J et al 10 (2009), Saket RK et al 1 (2016) and Yadav D et al 4 (2016) which revealed that squamous cell carcinoma was the most common histological subtype followed by adenocarcinoma.…”

Clinicopathological Profile of Patients with Lung Carcinoma in a Tertiary Care Center

“…The average age of our patients was 63 years, with male predominance, which is similar to that reported in other Indian studies conducted by Prasad et al 8 (57 years), Dey et al 9 (60.37 years), and Kaur et al 10 (58.6 years). The male to female ratio was 6.1:1, which is similar to that found in other studies conducted in India by Viswanathan et al 11 (ratio: 6.9:1) and Yadav et al 12 (ratio: 6:1).…”

Of multidetector computed tomography (MDCT) in evaluation of lung nodule with histopathological correlation

“…Out of all patients 73 % patient had enlarged mediastinal lymph nodes, 51 % had subcarinal and 44 % had hilar lymph node involvement. There were similar findings seen in study done by Yadav et al 18 The amount of enhancement of 100 lung nodules were studied by measuring the CT numbers of both benign and malignant nodules on both pre contrast scan and post contrast scan showing maximum enhancement. There was no statistically significant difference between heterogeneity of contrast enhancement.…”