Operative and Pathologic Survey of 50 Cases of Peripheral Lung Tumors Scanned with 67 Gallium

Abstract

Pulmonary scintiscanning with 67 gallium citrate allows the detection of nearly 100 percent of primary lung tumors. The method also permits visualization of mediastinal lymph node involvement. The scan picture, however, may give positive results also in granulomatous or inflammatory lesions. It therefore does not allow differentiation between neoplastic and nonmalignant diseases, or between primary or secondary lung tumors. The operative survey of 50 consecutive cases of peripheral lung masses and tumors showed agreement between positive scans and pathologic findings of malignant neoplasm in 94 percent of the cases while only 54 percent of those with definite nonmalignant disease had negative findings on scan. All cases showing hilar and mediastinal lymph node involvement had operative confirmation. No cases with pathologic findings of only hilar lymph node hyperplasia or simple anthracosis, on the contrary, had shown an uptake of the radionuclide outside the tumor. Scanning with 67 gallium seemed particularly useful to detect the presence of metastases involving either the regional lymph nodes or the mediastinum, and to show whether some radiologic pictures of suspected lymph node metastases are merely hyperplastic reactions.