TB in Asia favors lesser reliance on PET scanning and greater use of nonsurgical biopsy over surgical diagnosis or surveillance. Practitioners in Asia are encouraged to use these adapted consensus guidelines to facilitate consistent evaluation of pulmonary nodules.
Recent advances on CT scan imaging followed by further investigation techniques (if applicable) such as endobronchial ultrasound (EBUS), fiberoptic bronchoscopy (FOB), video assisted thoracoscopy (VATS), surgery and pathological diagnosis have played a key role in the early and accurate diagnosis Abstract OBJECTIVE: To determine whether the American College of Chest Physicians' lung nodule screening recommendation is an effective tool in diagnosing Asian patients with pulmonary nodules. MATERIALS AND METHODS: This is a retrospective study of 36 patients from 2012-2014 that were identified to have had pulmonary nodules through chest CT scan results. The data collected from patients were evaluated then illustrated to find out the nature of lung nodules among Asian population. The pulmonary nodule is based on size alone regardless of other morphology for instance border, calcification etc. RESULTS: Out of 36 patients, 23 were diagnosed with tuberculosis (TB), 19 tested positive for lung malignancy, 5 cases of TB co existing with cancer and 6 cases of non-tuberculous mycobacterium (NTM) infection. The types of lung cancer found were 7% small cell lung cancer, 7% squamous cell lung cancer and 86% adenocarcinoma. Nodule sizes were classified into 3 groups according to measurement. 4.5-11 mm (100% TB and 0% cancer), 12-20 mm (60% TB and 40% cancer) and 21-88 mm (52% TB and 48% cancer). CONCLUSION: Lung nodule evaluation among Asian patients requires specific guidelines that consider the high prevalence of tuberculosis and other infections. The statistical results from our study proves that the American College of Chest Physicians' lung nodule screening recommendation, if practiced by Asian physicians, should be revised according to the current health status and presence of other diseases of the Asian population.
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