Lung Cancer |

The Utility of Bronchoscopy Following Computed Tomography of Thorax in the Assessment of Hemoptysis Presenting to a Rapid Access Lung Cancer Clinic FREE TO VIEW

Oisin O'Connell, MBBCh; Emily Bredin; Colette Murphy; Yvonne Gahan; Michael Henry; Dermot O'Callaghan; Marcus Kennedy
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Interventional Pulmonology, MD Anderson Cancer Institute, Houston, TX

Chest. 2014;146(4_MeetingAbstracts):604A. doi:10.1378/chest.1993174
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SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Haemoptysis ia a common symptom in patients presenting to a rapid access lung cancer clinic (RALC) and its evaluation currently utilises significant resources.

METHODS: Medical records of all patients referred to two national tertiary RALC referral centers (assessment time <2wks) with haemoptysis who underwent computed tomography (CT) scanning and bronchoscopy over a one year period were reviewed. The gold standard for the cause of haemoptysis was a composite of endoscopic, radiological, pathological and microbiological diagnosis, with at least 6 months clinico-radiological follow up. CT findings were sub-categorised into those with or without an attributable cause for haemotpysis.

RESULTS: Out of 1159 RALC referrals, 257 (22%) patients (143M, 114 F) reported haemoptysis and all underwent CT scanning and bronchoscopy. 167 (65%) patients had an attributable cause for haemoptysis identified on CT (lung cancer n=64; infection n=83; bronchiectasis n=16; and pulmonary embolism n=2). A histological diagnosis of lung cancer from bronchoscopic sampling was established in 44/64 cases. In subgroup analysis, patients with haemoptysis >14 days duration had an increased liklihood of lung cancer in comparison to infection (p<0.05). There were no false negative CT scans for lung cancer.

CONCLUSIONS: One quarter of patients referred to our RALC with haemoptysis had lung cancer. No patient presenting with haemotysis had a false negative CT for lung cancer. In subgroup analysis, patients with persistent haemoptysis were more likely to have lung cancer.

CLINICAL IMPLICATIONS: State of the art CT imaging of the thorax is highly sensitive at excluding lung cancers large enough to cause haemoptysis.

DISCLOSURE: The following authors have nothing to disclose: Oisin O'Connell, Emily Bredin, Colette Murphy, Yvonne Gahan, Michael Henry, Dermot O'Callaghan, Marcus Kennedy

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