Peripheral Bronchogenic Carcinoma Research Articles

Prediction of the benign and malignant nature of masses in COPD background based on Habitat-based enhanced CT radiomics modeling: A preliminary study.

It is difficult to differentiate between chronic obstructive pulmonary disease (COPD)-peripheral bronchogenic carcinoma (COPD-PBC) and inflammatory masses. This study aims to predict COPD-PBC based on clinical data and preoperative Habitat-based enhanced CT radiomics (HECT radiomics) modeling. A retrospective analysis was conducted on clinical imaging data of 232 cases of postoperative pathological confirmed PBC or inflammatory masses. The PBC group consisted of 82 cases, while the non-PBC group consisted of 150 cases. A training set and a testing set were established using a 7:3 ratio and a time cutoff point. In the training set, multiple models were established using clinical data and radiomics texture changes within different enhanced areas of the CT mass (HECT radiomics). The AUC values of each model were compared using Delong's test, and the clinical net benefit of the models was tested using decision curve analysis (DCA). The models were then externally validated in the testing set, and a nomogram of predicting COPD-PBC was created. Univariate analysis confirmed that female gender, tumor morphology, CEA, Cyfra21-1, CT enhancement pattern, and Habitat-Radscore B/C were predictive factors for COPD-PBC (P< 0.05). The combination model based on these factors had significantly higher predictive performance [AUC: 0.894, 95% CI (0.836-0.936)] than the clinical data model [AUC: 0.758, 95% CI (0.685-0.822)] and radiomics model [AUC: 0.828, 95% CI (0.761-0.882)]. DCA also confirmed the higher clinical net benefit of the combination model, which was validated in the testing set. The nomogram developed based on the combination model helped predict COPD-PBC. The combination model based on clinical data and Habitat-based enhanced CT radiomics can help differentiate COPD-PBC, providing a new non-invasive and efficient method for its diagnosis, treatment, and clinical decision-making.

Clinical value of CT Airbronchogram in diagnosis of Peripheral Bronchogenic Carcinoma

Objective To explore the clinial value of airbronchogram in diagnosis of peripheral lung cancer (diameter≤3). Methods Comparing study between thin section CT and pathology was done on 174 nodules (129malignant and 45 benigin) in 150 patients. Results Thin section CT showed 30 cases (23%) of airbronehogram in nodules,only seen in bronchioalveolocarcinoma, adenocarcinoma and squamous cell carcinoma (significance difference). Conclusion Airbronchogram in peripheral small nodules was a certain sign of malignant nodule. The sign suggested diagnosis of histologic types in lung center. Key words: Airbronchogram; Lung neoplasms; Tomogaphy, X-ray; Computed

Preliminary assessing no-surgical treatment response in bronchogenic carcinoma with three-phase contrast material-enhanced MRI

Objective The aim of this study was to evaluate the efficacy of three-phase contrast material-enhanced MRI in assessing no-surgical treatment response in peripheral bronchogenic carcinoma preliminarily.

Adjacent parenchymal abnormalities in peripheral bronchogenic carcinoma: correlation of thin-section CT with histology.

Our purpose is to correlate thin section CT of peripheral bronchogenic carcinomas with histologically detected lymphatic or vascular invasion. Retrospective 3-year database search revealed 186 surgical resections for primary bronchogenic carcinoma, of which 58 had available preoperative imaging performed at our institution. Cases with prior surgery, nonconfirmatory pathology, remote imaging, or central location were excluded, resulting in a study population of 42 patients, 25 men, 17 women, with a mean age of 69 years. Imaging with 1-3 mm collimation was performed within a mean of 32 days prior to surgery. Histologic diagnoses included adenocarcinoma (n = 24, 57%), squamous cell carcinoma (n = 13, 31%), large cell carcinoma (n = 4, 10%), and small cell carcinoma (n = 1, 2%), with a mean tumor size of 27 mm. Three radiologists blindly and independently recorded bronchovascular thickening, septal and nonseptal opacities, and the extent of each beyond tumor margins: 1) <5 mm, 2) 5-10 mm, and 3) >10 mm. Lymphangio-invasion was correlated with imaging findings, tumor size, and histology. Adjacent parenchymal abnormalities were recorded in 40 (95%) of 42 masses, with isolated nonseptal opacities representing the most frequent abnormality in 21 (50%), followed by bronchovascular thickening in 16 (38%), and septal opacities in 12 (29%). Lymphangio-invasion was present in 16 (38%) of cases. The frequency of lymphangio-invasion was highest (53%) in cases with 2 or more positive findings, and extension beyond 10mm from the tumor margin. This trend did not achieve statistical significance by ROC analysis. Lymphangio-invasion was positively correlated with tumor size, P =.03, but not histology.In conclusion, parenchymal abnormalities beyond tumor margins shown by CT may be due to lymphangio-invasion but imaging findings did not reliably distinguish cases with and without lymphangio-invasion.

Chest wall infiltration by lung cancer: value of thin-sectional CT with different reconstruction algorithms.

The aim of this investigation was to evaluate whether thin-sectional CT with different reconstruction algorithms can improve the diagnostic accuracy with regard to chest wall invasion in patients with peripheral bronchogenic carcinoma. Forty-one patients with intrapulmonary lesions and tumor contact to the thoracic wall as seen on CT staging underwent additional 1-mm CT slices with reconstruction in a high-resolution (HR) and an edge blurring, soft detail (SD) algorithm. Five criteria were applied and validated by histological findings. Using the criteria of the intact fat layer, HRCT had a sensitivity of 81 % and a specificity of 79 %, SD CT had a sensitivity of 96 % and a specificity of 78 %, and standard CT technique had a sensitivity of 50 % and a specificity of 71 %, respectively. Regarding changes of intercostal soft tissue, HRCT achieved a sensitivity of 71 % and a specificity of 96 %, SD CT had a sensitivity of 94 % and a specificity of 96 % (standard CT technique: sensitivity 50 % and specificity 96 %). For the other criteria, such as pleural contact area, angle, and osseous destruction, no significant differences were found. Diagnostic accuracy of chest wall infiltration can be improved by using thin sectional CT. Especially the application of an edge-blurring (SD) algorithm increases sensitivity and specificity without additional costs.

Factors affecting the radiologic appearance of peripheral bronchogenic carcinomas.

The use of high-resolution computed tomography and magnetic resonance imaging have allowed the detailed description of morphologic findings associated with lung cancer. In particular, the desmoplastic response of lung tissue to tumor growth has not been adequately described. This article reviews roentgenologic and pathologic correlations of primary lung carcinomas. An irregular or indistinct tumor margin may be caused by tumor infiltration, an irregular desmoplastic response to the tumor growth, or irregular contraction in the central portion of the tumor. Solid tumor growth, on the other hand, may be associated with a well-defined tumor margin, with or without displacement of adjacent anatomical structures.

Pulmonary parenchymal manifestations surrounding small peripheral masses: pathologic correlation with chest radiographs and diagnostic value.

We evaluated pathologic correlations of pulmonary parenchymal manifestations surrounding small peripheral masses and their usefulness in differentiating small peripheral bronchogenic carcinomas from tuberculomas. We evaluated 29 resected lobe specimens with 1.5- to 3.5-cm solitary pulmonary masses, including 24 carcinomas and five tuberculomas. These specimens were prospectively studied with preoperative chest radiographs, postoperative specimen radiographs, 10- to 15-microns-thick wholemount sections, and 5-microns-thick slices. A total of 100 chest X-rays and conventional tomography scans of 1- to 3-cm peripheral pulmonary masses, including 60 carcinomas and 40 tuberculomas, were retrospectively reviewed and analyzed. The pulmonary parenchymal manifestations surrounding the masses presented as small infiltrates and nodular protrusions, thickened strands, and "double track" shadows, which extended from the proximal margin of five tuberculomas (100%, 5 of 5) and from the distal margin of 17 carcinomas (71%, 17 of 24). These pulmonary changes represented caseous material spreading from tuberculomas into the proximal bronchus and alveolar inflammatory exudation distal to the carcinomas. The proximal pulmonary manifestations were significantly more frequent in tuberculomas than in carcinomas (p < .01), whereas the distal pulmonary manifestations were more often found in carcinomas than in tuberculomas (p < .01). The radiologic findings of the pulmonary parenchymal manifestations proximal or distal to the masses may be valuable radiologic signs for distinguishing between tuberculomas and small peripheral bronchogenic carcinomas, even though there is still considerable crossover between the two disease populations in the findings.

Flexible Bronchoscopy Without Fluoroscopy in Peripheral Lung Tumors

The use of bronchoalveolar lavage (BAL) to investigate peripheral bronchogenic carcinomas produces a variable yield and its significance when performed without the aid of fluoroscopy has not been established. To assess the relevance of BAL in the diagnosis of peripheral lung tumors, we prospectively analyzed the outcome of 22 flexible bronchoscopies (FFB) without fluoroscopy in peripheral lung cancer patients. The FFB provided a 45.5% yield. The ancilliary procedures carried out provided the following yields: bronchial lavage, 28.6%; BAL, 36.8%; bronchial brushing, 28.6%; brush lavage, 28.6%; and postbrushing bronchial lavage, 31.2%. The diagnostic yield from BAL was not statistically better than that of the other procedures. The highest yield with the lowest number of endoscopic methods was achieved with a combination of BAL and brushing lavage. Adding other procedures to this combination did not improve the diagnostic yield.

Regional and systemic CD4 and CD8 subsets in bronchogenic carcinoma : Liss HP, Baumann MA, Paul CC, Payne CB Jr. Department of Medicine, Wright State University School of Medicine, Dayton, OH. Neth J Med 1991;39:333–7

We studied lung and blood lymphocytes from 12 asymptomatic patients with peripheral bronchogenic carcinoma. Bronchoalveolar lavage was performed in the lung segment with tumor and a contralateral uninvolved lung segment and analyzed separately. After partial removal of macrophages by plastic adherence, cells were labeled with markers for CD4 and CD8 and analyzed by flow cytometric analysis. We found no significant difference in the percentages of mononuclear cells in either immune subset when comparing the lung containing tumor with the uninvolved lung. We did find, however, a depressed CD4/CD8 ratio in the peripheral blood. We conclude that a lung carcinoma does not change the local immunologic milieu of the lung parenchyma containing the carcinoma. It is not clear if the immunologic findings in the lungs and blood are due to the bronchogenic carcinoma, smoking, or the underlying chronic obstructive pulmonary disease.

Bronchus sign on CT in peripheral carcinoma of the lung: value in predicting results of transbronchial biopsy.

The bronchus sign on CT represents the presence of a bronchus leading directly to a peripheral pulmonary lesion. We investigated the value of this sign in predicting the results of transbronchial biopsy and brushing in 33 consecutive cases of proved peripheral bronchogenic carcinoma studied with thin-slice CT (2-mm-thick sections). The bronchus sign was seen on CT in 22 patients and was absent in 11. Transbronchial biopsy and brushing showed peripheral carcinoma in 13 (59%) of 22 patients in whom the bronchus sign was seen on CT and in only two (18%) of 11 patients in whom it was not seen. The difference is statistically significant (Fisher's exact test, p = .029). When analyzed by the order of involved bronchus, a 90% success rate of transbronchial biopsy and brushing was found in patients in whom the bronchus sign was seen at a fourth-order bronchus (p = .01). This compared with a success of 33% when the bronchus sign was seen at fifth-, sixth-, or seventh-order branches. Our results suggest that the bronchus sign at a fourth-order bronchus is valuable in predicting the success of transbronchial biopsy and brushing. The presence of the sign on CT may be useful in determining if the workup should include transbronchial biopsy and brushing or transthoracic needle aspiration in patients with peripheral lung lesions.

Wedge resection as an alternative procedure for peripheral bronchogenic carcinoma in poor-risk patients

Wedge resection as an alternative procedure for peripheral bronchogenic carcinoma in poor-risk patients

Wedge resection as an alternative procedure for peripheral bronchogenic carcinoma in poor-risk patients

Although lobectomy is the procedure of preference for patients with peripheral, clinical Stage I bronchogenic carcinomas, wedge resection of the tumor may be a satisfactory alternative in poor-risk patients. Between 1965 and 1982, 197 patients with peripheral bronchogenic carcinomas were operated upon. Clinical staging was established by radiography, bronchoscopy, and mediastinoscopy. Ninety-seven patients underwent lobectomies and 100 had wedge resections. The decision to perform the wedge resection was made preoperatively in the majority of cases based on the assessment of operative risks. Compared to lobectomy patients, those who had wedge resections were older (70.3 +/- 0.5 versus 64.9 +/- 0.5 years, p less than 0.001) and had a lower 1 second forced expiratory volume (1.56 +/- 0.03 versus 1.94 +/- 0.03 ml, p less than 0.001), a lower arterial oxygen tension (70.5 +/- 1.1 versus 75.6 +/- 1.2 mm Hg, p less than 0.01), and a higher arterial carbon dioxide tension (41.7 +/- 0.6 versus 38.7 +/- 0.3 mm Hg, p less than 0.001). Despite their compromised preoperative respiratory functional status, the wedge resection group had a 30 day operative mortality (3% versus 2.1%) and morbidity comparable to those of the lobectomy group. Actuarial life-table analysis indicates the cumulative survival rate at 2 years after operation to be virtually identical between wedge and lobectomy groups (72% versus 74%), and even at 6 years the differences in survival rates (69% versus 75%) were not statistically significant. We conclude, therefore, that by performing wedge resections in selected poor-risk patients, one may reduce the operative mortality and morbidity to an acceptable range without seriously compromising their long-term survival.

Pleural and chest wall invasion in bronchogenic carcinoma: CT evaluation.

CT scans of 47 patients who had peripheral bronchogenic carcinoma contiguous to the pleural surface and who had undergone thoracotomy were retrospectively reviewed. The CT features of the primary neoplasm that were analyzed included the angle and amount of contact with the adjacent pleural surface, associated pleural thickening, fat plane between the tumor and chest wall, rib destruction, and chest wall mass. CT was of limited predictive value in separating those patients who had parietal pleural/chest wall involvement from those who did not. The combination of two or three CT findings (obtuse angle, greater than 3 cm contact with pleural surface, associated pleural thickening) resulted in a sensitivity of 87% and a specificity of 59%. The clinical symptom of focal chest pain, while not as sensitive (67%) as CT, was much more specific (94%) for parietal pleura/chest wall invasion.

An Appraisal of En Bloc Resection of Peripheral Bronchogenic Carcinoma Involving the Thoracic Wall

Thirty-two patients with peripheral bronchogenic neoplasms adherent to the chest wall underwent en bloc pulmonary and thoracic wall resections. Presenting symptoms were thoracic wall pain (75 percent), hemoptysis (12.5 percent), and cough with weight loss (12.5 percent). Patients were selected for surgical resection only after a search for metastatic disease, including mediastinoscopy, showed negative results. A standard posterolateral thoracotomy incision was used which did not require skeletal reconstruction or prosthetic material for closure. There were nine major postoperative complications (28.8 percent), principally respiratory, and one operative death (3.1 percent). The five-year actuarial survival was 35 percent. None of the patients with regional lymph node involvement or positive chest wall margins lived more than two years after surgery. Preoperative irradiation performed in 12 patients (37.5 percent) improved operability, but did not significantly alter survival. These results indicate that patients with peripheral bronchogenic carcinoma involving the thoracic wall may be successfully managed with en bloc pulmonary and chest wall resection, particularly if surgery is performed in the early stage of the disease.

Segmental Resection for Bronchogenic Carcinoma: A Surgical Alternative for the Compromised Patient

Over a twenty-year period, 44 patients with peripheral bronchogenic carcinoma who were unable to tolerate major pulmonary resection underwent segmentectomy as an alternative to nonoperative management. There were 2 immediate postoperative deaths. Of 31 patients eligible, 36% survived five years, and the mean survival time approached four years. Excluding those patients with undifferentiated small cell carcinoma, segmental resection in this compromised group offered a good chance for cure while providing reasonable palliation, and this procedure should be considered as a surgical option to other modalities of treatment commonly offered to these individuals.

The Effect of Tumor Size and Location on Diagnosis by Fiberoptic Bronchoscopy

Evaluation of data from fiberoptic bronchoscopic procedures revealed that for peripheral bronchogenic carcinomas, the diagnostic yield was influenced by the size of the lesion and its distance from the hilum. Failure to diagnose visible carcinomas was related to inability to obtain deep specimens for biopsy. Biopsy, brushing, and washing were complementary procedures in diagnosing bronchogenic carcinomas.

Use of the Bronchofiberscope for Bronchial Brush Biopsy: Diagnostic Results and Comparison with Other Brushing Techniques

The flexible bronchofiberscope was used to perform bronchial brush biopsies in 75 patients with central, midlung and peripheral lung lesions suspected of being malignant. Of the 52 patients who had lung cancer, a positive or highly suspicious cytology was obtained in 46 (89 percent), compared to a diagnostic accuracy of 72 percent in a previous series using rigid, premolded catheters, and 82 percent using a mobile, controlled-tip catheter. Direct placement of the brush on endoscopically visible tumors produced positive results in 32 of 34 patients (94 percent), whereas only 14 of 18 patients (78 percent) with peripheral bronchogenic carcinomas were correctly diagnosed by indirect fiberoptic brushing under fluoroscopic control. In distal, inaccessible lesions, the problem may be solved using a mobile, controlled-tip catheter or the recently modified curette.

Survival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodules

Survival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodules

THE SOLITARY CIRCUMSCRIBED BRONCHOGENIC CARCINOMA. A RADIOLOGICAL STUDY OF 100 CASES.

The Solitary Circumscribed Bronchogenic Carcinoma. A Radiological Study of 100 CasesEric M. BatesonEric M. BatesonThe United Sheffield Hospitals*Present address: X-ray Dept., University College Hospital, Mona, Kingston, Jamaica.Search for more papers by this authorPublished Online:29 May 2014https://doi.org/10.1259/0007-1285-37-440-598SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutAbstractAn analysis of 100 solitary, circumscribed, bronchogenic carcinomas has been carried out with correlation of their radiological features with their histological type, clinical features and prognosis. Previous article Next article FiguresReferencesRelatedDetailsCited byRespiratory tractRespiratory TractEVALUATION AND MANAGEMENT OF SOLITARY AND MULTIPLE PULMONARY NODULESClinics in Chest Medicine, Vol. 13, No. 1The Solitary Pulmonary NoduleA calcified carcinoma of the lung and intracerebral metastasisJournal of Computed Tomography, Vol. 11, No. 4Evaluation of Pulmonary and Mediastinal MassesMedical Clinics of North America, Vol. 68, No. 6The Solitary Pulmonary NoduleRadiologic Clinics of North America, Vol. 21, No. 4Gutartige Primärtumoren der Bronchien und LungenSurvival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodulesThe Journal of Thoracic and Cardiovascular Surgery, Vol. 57, No. 1Radiology of the aspergillomaClinical Radiology, Vol. 18, No. 4 Volume 37, Issue 440August 1964Pages: 565-644 © The British Institute of Radiology History ReceivedOctober 01,1963Published onlineMay 29,2014 Metrics Download PDF