INTRODUCTIONLung carcinomas are a group of tumors that arise from any part of trachea, bronchi, bronchioles or the pulmonary parenchyma and can be derived from the cells of epithelium, mesenchyme and neural origin. Thus, it is a heterogenous entity both in the variety of cell type and in the biological behaviour of any particular cell type. Bronchogenic carcinoma is the most common cause of cancer-related death in men and second most common in women, worldwide. Imaging studies play a key role in the detection, staging and post-treatment follow up of patients with bronchogenic carcinoma. The strongest prognostic factor for survival in lung cancer cases is respectability of the tumor. Thus, accurate staging of the bronchogenic carcinoma is essential as the choice of treatment options ABSTRACT Background: Lung cancer is the most common cancer worldwide. Hence, timely diagnosis and accurate staging of the carcinoma is critical for the treatment and prognosis. So, this study was performed to evaluate the role of CT scan in diagnosis and staging of lung cancer. Methods: This was a prospective and observational study carried out over one and half years at a tertiary care hospital. The patients found to have abnormalities on chest X-ray suggestive of carcinoma were included in the study. Pre and post contrast CT scans were performed. Individual patient biopsies were done for histopathological staging. Results: Most patients belonged to 41-50 years age group with male preponderance (81.33%). Habit of smoking was prevalent among the lung cancer patients. Almost all masses (92%) showed heterogeneous contrast enhancement on CT. Additionally, there were calcifications, cavitation, hilar enlargement, pleural invasion, mediastinal lymphadenopathy and contiguous bone involvement. Adenocarcinoma was the most common (46.66%) form of cancer followed by squamous cell carcinoma (42.66%). For histopathological diagnosis, majority of patients (73.33%) were diagnosed using CT guided biopsy. In the remaining patients, USG guided biopsy or fibreoptic bronchoscopy were performed. The most common lobe affected by bronchogenic carcinoma was right upper lobe. The most common site of metastasis was pleura (22.66%) followed by bone (17.33%). Majority of the patients (41.33%) presented with TNM stage IV. Conclusions: CT scan as a modality for detection and staging of bronchogenic carcinoma is superior to chest radiograph. CT guided FNAC has a high success rate in evaluation of lung carcinoma.
Background: Evaluation of suspected biliary obstruction has traditionally involved a variety of imaging modalities including ultrasonography (US), computed tomography (CT), and invasive cholangiography. These techniques have limitations because of poor visualization of intra-ductal stones on US and CT and the need for invasive procedures like endoscopic retrograde cholangio-pancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC). Magnetic resonance cholangio-pancreatography (MRCP) is a non-invasive imaging modality that provides good visualization of the hepato-biliary system. Objective: To describe the MRCP appearance of pancreatico-biliary diseases and differentiating benign from malignant strictures, and also to determine sensitivity, specificity, and accuracy of MRCP in the detection of pancreatico-biliary diseases. Materials and Methods: A prospective study carried out over a period of 2 years. If on ultrasonography patient having pancretico-biliary disease then s/he would be selected for the study. Once the patient agrees to participate in the study, information is obtained as per the performa. MRCP was done in all participants. Result: The peak incidence of pancreatico-biliary diseases is seen in the age group of 61-70 years with 9 (22.5%) participants. Common presenting complaint were right upper quadrant pain seen in 37 (92.5%) patients followed by yellowish discoloration of skin and sclera, present in 29 (32.5%) of patients. The cases of cholangiocarcinoma predominated and was seen in 08 (20 %) patients followed by choledochal cyst in 06 (15 %) and cholelithiasis-choledocholithiasis in 6 (15%). Benign diseases were seen in 21 (52.5%) participants while malignant diseases in 19 (47.5%). Sensitivity and specificity of MR pancreatico-cholengiography scan for pancreatico-biliary diseases was nearly 95%. Also accuracy of diagnosis was also 95%. Conclusion: MRCP is providing useful criteria in differentiating benign from malignant strictures. MRI in combination with MRCP has the advantage of multiplanar capability, high tissue contrast, combining projectional, and cross sectional images in the evaluation of the biliary system. After the initial USG examination in these patients, the next investigation should be MRI with MRCP.
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