The Malignant Solitary Pulmonary Nodule Follow-Up Study

I enjoyed reading the article entitled "Approach to the Solitary Pulmonary Nodule," by Midthun and colleagues in the April 1993 issue of the Mayo Clinic Proceedings (pages 378 to 385). I was surprised, however, to note that the simplest clinical test for determining whether a solitary pulmonary nodule is malignant was not mentioned in the article. Sputum cytology is the most costeffective test available, and a positive diagnosis of malignant disease can have a 95% accuracy. In addition, I am sure that literally thousands of lung lesions have been diagnosed as malignant by sputum examination at the Mayo Clinic during the past century. Thus, I obviously wondered why this test was not mentioned. Sputum cytology was used in the National Cancer Institute study1 and was considered, at that time, "state of the art," but sputum diagnosis has improved tremendously with the experience obtained from fine-needle aspiration of lung lesions. This improvement has been demonstrated by several articles that have been published since the National Cancer Institute study.2"9 Therefore, sputum cytology is the most cost-effective, noninvasive procedure when findings are positive and should be the first test performed after a solitary pulmonary nodule has been detected roentgenographically.

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The Malignant Solitary Pulmonary Nodule Follow-Up Study

Cited by 8 publications

References 24 publications

Survival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodules

Survival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodules

Approach to the Solitary Pulmonary Nodule

Sputum Cytology

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