Diagnosis and staging of lung carcinoma with CT scan and its histopathological correlation

Abstract

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.

Role of image guided fine needle aspiration cytology of lung lesions in patients visiting Gandaki Medical College

“…In our study peak age of incidence was above 70 years however in the study done by Shah D et al 11 the age group ranged from 41-50 years and Abdulhamed T et al 12 from 45-78 years which is not concordance with our study. The mean age in our study was 68.4 years and similar findings were observed in the study by Shrestha M.K et al 13 with a mean age of 67.32 years.…”

Of multidetector computed tomography (MDCT) in evaluation of lung nodule with histopathological correlation

“…The most common histopathological subtype was adenocarcinoma which accounted for 41 % cases. This is in concordance with studies done by Shad et al, 19 Modi et al, 20 Babu et al, 21 Gangopadhyay et al 4 that showed that there was an increasing trend in the incidence of adenoma, contrary to the studies done by Adaikkalavan et al, 16 Rawat et al, 15 Saha et al, 9 Ahmed et al, 6 Narayan et al 8 In all these studies squamous cell carcinoma was the most predominant subtype. Adenocarcinoma was seen more at peripheral location (56.84 %), than central (19.04 %).…”

Staging of Bronchogenic Carcinoma at Tertiary Health Care Centre with Multidetector Computed Tomography and Histopathological Correlation

“…In our study adenocarcinoma was seen to be the most common histological subtype accounting for 46.34% of cases. This is in concordance with the study by Malik PS et al 6 (2013), Krishnamurthy A et al 12 (2012), Shad D et al 7 (2017), Dr. Modi M et al 19 (2016) and Dr. Babu S et al 5 (2016) which showed an increasing trend in the incidence of adenocarcinoma. However, our findings are contrary to the studies done by Dr. Adaikkalavan et al 18 (2017), Rawat J et al 10 (2009), Saket RK et al 1 (2016) and Yadav D et al 4 (2016) which revealed that squamous cell carcinoma was the most common histological subtype followed by adenocarcinoma.…”