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Poster Presentations: Tuesday, November 2, 2010 |

Evaluation of Different Diagnostic Procedures in the Diagnosis of Lung Cancer FREE TO VIEW

Soumya Bhattacharjee, MD; Sourin Bhuniya, MD; Ramendu S. Mukherjee, MD; Jaydip Deb, MD; Sudipta Pandit, MD; Arunabha D. Chaudhuri, MD; Subhasis Mukherjee, MD; Pulakesh Bhanja, MD
Author and Funding Information

R G Kar Medical College & Hospital, Kolkata, India



Chest. 2010;138(4_MeetingAbstracts):255A. doi:10.1378/chest.10641
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Abstract

PURPOSE: There is an array of diagnostic tools available for detection of lung cancer. The optimal approach is one that leads to a conclusive diagnosis in shortest possible time, with minimal cost and least morbidity.

METHODS: The study covers 80 adult patients of cytological or histo-pathological proved lung carcinoma from a tertiary hospital between March 2008 and February 2009. Those with metastasis in lungs were excluded. The diagnostic tools evaluated include sputum cytology, Fibre-optic bronchoscopy (FOB) with examination of bronchial brushings, washings and biopsy specimens; Computed Tomography (CT) guided fine needle aspiration cytology (FNAC) of lung lesions and biopsy of peripheral lung lesions by Vim tru-cut needle.

RESULTS: Sputum cytology for malignant cells done in all cases was positive in 27 cases (33.75%). Yield was more in central than peripheral lesions (72.72% vs. 18.18% respectively). FOB was done in 52 patients and bronchial biopsy was positive in 40 (76.92%) whereas brushing and washing was positive in 25 (48%) and 23 (44.23%) patients respectively. CT guided FNAC of lung lesion was done in 39 patients and was positive for malignancy in 36 patients (92.3%). Seven patients with peripheral lesions were selected for tru-cut lung biopsy and malignancy was found in all of them (100%). Complications like pneumothorax was encountered in two (28.5%) cases of tru-cut lung biopsy and four (10.25%) cases of CT guided FNAC, hemoptysis was seen in three (5.76%) cases of FOB and one (2.56%) case of CT guided FNAC and bronchospasm occurred after FOB in 10 (19.23%) cases.

CONCLUSION: CT guided FNAC is a safe and highly sensitive diagnostic tool for lung cancer. The yield in FOB depends upon the site, size of lesion and the experience of bronchoscopist. Tru-cut lung biopsy is highly sensitive for peripheral lesions but is relatively unsafe.

CLINICAL IMPLICATIONS: The judicious selection of the right diagnostic tool for lung cancer should be based on the knowledge of merits, demerits, sensitivity, limitations, complications and cost effectiveness of each procedure.

DISCLOSURE: Sourin Bhuniya, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM


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