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Superficial endobronchial lung cancer: radiologic-pathologic correlation.

Han NJ, Song KS, Lee KH, Seo JB, Lee JS, Lim TH, Kang GH - Korean J Radiol (2002 Oct-Dec)

Bottom Line: The CT and histopathologic findings were compared.Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology.

Materials and methods: This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared.

Results: Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.

Conclusion: CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

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Related in: MedlinePlus

A 59-year-old man with blood-tinged sputum.A, B. Chest radiographs show segmental collapse in the anterior segment of the left upper lobe.C. CT scans (10-mm-thickness) depict bronchial obstruction and segmental atelectasis of the anterior segment of the left upper lobe.D. Photomicrography of pathologic specimen shows a polypoid mass in the anterior segmental bronchus of the left upper lobe (arrows), its invasive component extending through the full thickness of the bronchial wall (not shown here) (original magnification, ×400; hematoxylin-eosin staining).
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Figure 3: A 59-year-old man with blood-tinged sputum.A, B. Chest radiographs show segmental collapse in the anterior segment of the left upper lobe.C. CT scans (10-mm-thickness) depict bronchial obstruction and segmental atelectasis of the anterior segment of the left upper lobe.D. Photomicrography of pathologic specimen shows a polypoid mass in the anterior segmental bronchus of the left upper lobe (arrows), its invasive component extending through the full thickness of the bronchial wall (not shown here) (original magnification, ×400; hematoxylin-eosin staining).

Mentions: A comparison between the CT and histopathologic findings, based on the nature of the endobronchial lesion, is made in Table 3. At CT, five of the histopathologically diagnosed endobronchial nodules were correctly interpreted (Fig. 2), three were identified as bronchial obstruction (right upper lobar bronchus, anterior segmental bronchus of the left upper lobe, lateral basal segmental bronchus of the left lower lobe) (Fig. 3), two as bronchial wall thickening and stenosis (anterior segmental bronchus of the right upper lobe and superior segmental bronchus of the right lower lobe), and one as completely normal (left upper lobar bronchus). Of the six lesions in which irregular bronchial wall thickening was identified histopathologically, two were missed at CT; these were located in the right upper lobar bronchus (Fig. 4) and the superior segmental bronchus of the left lower lobe.


Superficial endobronchial lung cancer: radiologic-pathologic correlation.

Han NJ, Song KS, Lee KH, Seo JB, Lee JS, Lim TH, Kang GH - Korean J Radiol (2002 Oct-Dec)

A 59-year-old man with blood-tinged sputum.A, B. Chest radiographs show segmental collapse in the anterior segment of the left upper lobe.C. CT scans (10-mm-thickness) depict bronchial obstruction and segmental atelectasis of the anterior segment of the left upper lobe.D. Photomicrography of pathologic specimen shows a polypoid mass in the anterior segmental bronchus of the left upper lobe (arrows), its invasive component extending through the full thickness of the bronchial wall (not shown here) (original magnification, ×400; hematoxylin-eosin staining).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713844&req=5

Figure 3: A 59-year-old man with blood-tinged sputum.A, B. Chest radiographs show segmental collapse in the anterior segment of the left upper lobe.C. CT scans (10-mm-thickness) depict bronchial obstruction and segmental atelectasis of the anterior segment of the left upper lobe.D. Photomicrography of pathologic specimen shows a polypoid mass in the anterior segmental bronchus of the left upper lobe (arrows), its invasive component extending through the full thickness of the bronchial wall (not shown here) (original magnification, ×400; hematoxylin-eosin staining).
Mentions: A comparison between the CT and histopathologic findings, based on the nature of the endobronchial lesion, is made in Table 3. At CT, five of the histopathologically diagnosed endobronchial nodules were correctly interpreted (Fig. 2), three were identified as bronchial obstruction (right upper lobar bronchus, anterior segmental bronchus of the left upper lobe, lateral basal segmental bronchus of the left lower lobe) (Fig. 3), two as bronchial wall thickening and stenosis (anterior segmental bronchus of the right upper lobe and superior segmental bronchus of the right lower lobe), and one as completely normal (left upper lobar bronchus). Of the six lesions in which irregular bronchial wall thickening was identified histopathologically, two were missed at CT; these were located in the right upper lobar bronchus (Fig. 4) and the superior segmental bronchus of the left lower lobe.

Bottom Line: The CT and histopathologic findings were compared.Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology.

Materials and methods: This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared.

Results: Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one.

Conclusion: CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

Show MeSH
Related in: MedlinePlus