Radiological findings of primary lung cancer

Yoo, H S; Choi, B S; Sung, K J; Choi, K H

Abstract

It seems that primary lung cancer is increasing in frequency and the problems presented by the carcinoma ofthe lung have been explored on many occasions in view of clinical and radiological aspects in Korea. However, noliterary reports on a large series of radiological findings of bronchogenic carcinoma have been yet published.This presen study is mainly to analyse the radiological manifestation of primary lung cancer by the cell type andalso to observe the relationship of carcinoma of the lung to tuberculosis which is prevalent in Korea.Histologically proven 200 cases of lung cancer during the period of 8 years were reviewed with plain chest films,tomogram, bronchography and esophagography. The results are as follows ; 1. Male to Female sex ratio was 3.8:1.Incidence was most common in 6th decade as 43%. 2. Cell types of primary lung cancer are as follow: Sq. cell Ca,45%, Undifferenciated Ca, 15% Oat cell Ca.22%, Adeno Ca. 17%, and Alveolar cell Ca. 3% 3. The most commonradiological abnormality was the mass shadow in either hilum and/or peripheral lung field, and the next beingatelectasis. Bulky nodal mass was most frequently seen in oat cell Ca. and the peripheral mass in adenocarcinoma.4. No mass measured less than 2cm in size and most of them was over 6cm in mean diameter. 5. Solitary pulmonarynodules was seen in 10% and its mean size was 5.8cm and had smooth, lobulated margin without calcification. 6.Mediastinal widening was the most frequent finding in oat cell Ca. and undifferenciated carcinoma. Aden ocarcinomashowed peripherally located mass with frequent chest wall invasion as comparied with other cell type. Alveolarcarcinoma showed characteristic small nodular or granular infiltration without hilar node enlargement. 7. Cavitarycarcinoma of the lung was 4 cases (2%) and all had relative thick wall and 2 showed fluid level. 8. Other minorfindings include obstructive pneumonitis and lymphangitic metastasis and pleural effusion. 9. Coexistence ofpulmonary tuberculosis and lung cancer was 37 cases (18.5%), of which 20 cases had developed lung cancer in thesame location with previous pulmonary tuberculosis while 17 cases in other location. 10. There was no occult lungcancer. Most of our cases were in late inoperable stage and early detection of lung cancer should be emphasized bymeans of intensive radiological and clinical approach.