A descriptive analysis of lung and pleural tumours in a premier referral centre in Sri Lanka

Abstract

Introduction: This study describes pathological findings of lung and pleural neoplasms among a cohort of Sri Lankan patients. Methods A descriptive cross-sectional study was conducted among patients with lung and pleural tumours referred to National Hospital for Respiratory Diseases in 2017. Patients who underwent biopsy under direct vision or radiological guidance were included. Contrast Enhanced Computerized Tomography (CECT) findings were correlated with the histological diagnosis. Results The population was aged 8-93[mean (SD) =58.4(13.3)] years. Of 396 patients, 252(63.6%) were males. Majority (n=324, 81.4%) had lung tumours while 72(18.2%) had pleural tumours. Malignant neoplasms were found in 373(n=94.2). Of them, majority (n=180, 45.5%) were core biopsies, followed by lobectomies (n=77, 19.4%). Commonest benign lung tumour was hamartoma (n=13, 3.3%). Schwannoma was the commonest benign pleural tumour (n=3, 0.8%). Among the primary malignant lung tumours, adenocarcinoma was the commonest (n=124, 31.3%). Six (1.5%) primary malignant pleural neoplasms (mesotheliomas) were found. Among the metastatic deposits in the lung, the majority was colorectal adenocarcinomas (n=9, 2.3%). The sensitivity, specificity, positive and negative predictive values of CECT in discriminating malignant lung and pleural tumours were 94.6%, 90.9%, 99.3%, and 54.1% respectively. A one-way ANOVA showed significant differences in the distribution of age among different types of masses [F (5,396) =2.759, p=.018]. The age of patients with benign lung neoplasms (mean=51.3±17.4 years), was less compared to the malignant pleural tumours and primary malignant lung tumours. Primary malignant lung tumours predominated among males [χ2 (5,396) =27.463, p=.000]. Conclusions Adenocarcinoma was the commonest primary lung tumour (Male: Female=1.6:1). There was a male predominance in primary malignant lung tumours. CECT has a poor negative predictive value in discriminating malignant neoplasms of lung and pleura.