Chest X-ray of lung cancer: Association with pathological subtypes

Abstract

Background: Chest radiography is an essential initial investigation for the suspected cases of bronchogenic carcinoma and can be a predictor of malignancy. Aims: To assess the radiographic presentation and distribution of the different pathological cell types of lung cancer in our hospital. Materials and Methods: A total of 125 consecutive suspected patients with lung cancer, who had initial chest X-ray lesions suspicious of malignancy (mass lesion, nodules, pleural effusion, evidence of bronchial obstruction such as collapse, unresolved consolidation, etc.), were selected as the study population. The contrast-enhanced computed tomography (CT) scan of the thorax, CT-guided fine-needle aspiration cytology, fiberoptic bronchoscopy and Tru-cut biopsy were performed in the patients as feasible to find out the pathological cell type of bronchogenic carcinoma. Then, the chest X-rays were clinically correlated in all the lung cancer cases. In addition, the relationship of chest X-ray with the pathological cell types was assessed in the cases of lung cancer. The data were presented and analysed by the standard statistical method. Results: In our study, squamous cell carcinoma was the predominant cell type (47.12%) followed by adenocarcinoma (29.81%). Squamous cell carcinoma and small cell carcinoma commonly presented as central lesions, whereas adenocarcinoma and large cell carcinoma manifested most frequently as peripheral lesions. The common radiographic presentation of squamous cell carcinoma was collapse (38.78%) followed by unresolved consolidations (28.57%) and masses, whereas adenocarcinoma mostly presented as nodules (38.71%) followed by pleural effusion (29.03%). Small cell carcinoma, large cell carcinoma and undifferentiated carcinoma mostly manifested as mass lesion on chest radiography. Conclusion: Chest roentgenography can provide a clue about the pathological cell types of bronchogenic carcinoma, especially in the cases of hilar or parahilar lesions, collapse, non-resolving consolidations and effusions.