The Role of Bronchography in the Diagnosis of Bronchogenic Carcinoma

The Significance of a Blocked Bronchus in the Assessment of Bronchogenic Carcinoma

“…(1) 92% of cases of bronchial carcinoma were associated with a demonstrable bronchial occlusion. confirming the findings of Wilt et al (1959) and Rinker et al (1968). This association is hardly surprising in view of the lateness in the natural history when even "early" cases are detected.…”

“…It has been estimated that a lung carcinoma becomes visible in a chest radiograph only during the last 25y0 of its natural history (Garland, 1966) . Mention should be made of the rare central carcinoma, showing predominantly centrifugal growth and a mediastinal mass but associated with a normal bronchogram (Wilt et al, 1959).…”

“…In the centres where bronchography has been widely employed in the assessment of bronchogenic carcinoma, the discovery of a blocked bronchus has been accorded great diagnostic significance. For example, one study of 1,408 bronchograms showed a blocked bronchus in 89% of 236 histologically proven lung cancers and only 3 false positive cases (Wilt et al, 1959). Similarly, in a review of 262 bronchograms a bIocked bronchus was associated with bronchogenic carcinoma in 94.2% of a series which contained 97 proven cases of carcinoma (Rinker et al, 1968).…”

“…The asthma case did, however, show occluded bronchi (including a lobar bronchus) in both lungs, and a tubular filling defect in the posterior segmental bronchus of the left upper lobe was demonstrated in the case of a pulmonary infarct. This is presumed to have been blood clot, a possible cause of bronchial occlusion in any case of recent haemoptysis (Wilt et al, 1959). Case 7A is a patient who was shown to have a cavitating mass in the right lung.…”

The early diagnosis of lung cancer

“…Obstruction in a peripheral bronchus may be detected by bronchography and, although not diagnostic of a carcinoma, it may offer sufficient evidence to warrant a thoracotomy (Wilt et al, 1959;Bignall, 1966). The commonest and most conclusive bronchographic sign is abrupt bronchial obstruction according to Mason & Templeton (1966) and was responsible for diagnosis and localization in 89%4 of patients with lesions in major, second and third order bronchi.…”