Diagnosis of Peripheral Lung Cancer in Cases of Tumors 2 cm or Less in Size

Abstract

This study evaluates the results of preoperative diagnosis on 108 resected cases of peripheral lung cancer with a tumor size of 2 cm or less. Transbronchofiberscopic curettage was performed in 85 cases under x-ray TV fluoroscopy. Only 65 of 85 patients were positive on the initial bronchoscopy (76.5 percent), with repeated bronchoscopy, and 71 of 85 were positive for malignant cells (83.5 percent). The cases for which diagnosis could not be obtained with curettage were those in which the tumor shadow was not visible by x-ray TV fluoroscopy, those in which the lesions arose extramurally compressing the bronchi, or in cases of subpleural lesions. Curettage did not yield a diagnosis in cases with lesions less than 1.1 cm. In cases of small lung cancer lesions, peripheral transbronchofiberscopic curettage should be expected to yield a false-negative rate of approximately 15 percent. Therefore, even when the results of curettage are negative, further detailed examinations including needle biopsy, are necessary to obtain a definitive diagnosis.