Etiology of size based pulmonary nodules in Asia.

Abstract

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.

Evaluation of Pulmonary Nodules

“…One recent study from Thailand also observed a very high prevalence of TB in nodules # 8 mm but especially in smaller nodules (4.5-11 mm). 27 Compared with the CHEST guidelines, the expert panel suggested long-term CT surveillance (3 years and beyond) of small nodules in Asian individuals with a higher risk profile. Although the expert panel acknowledged that there are no data to explicitly support this approach, the recommendation is based on the natural history of slowly growing early-stage adenocarcinoma.…”

Prevalence and clinical characteristics of malignant lung nodules in tuberculosis endemic area in a single tertiary centre

“…We calculated the sample size based on the etiology of a size-based lung nodule in Asia by SawangSaenghirunvattana et al . " The prevalence (P) of the malignant nodule is 0.25 or 25% [ 10 ].…”

“…Data were obtained from the radiological picture archiving and communication system (PACS) database and the subject's case notes. We calculated the sample size based on the etiology of a size-based lung nodule in Asia by SawangSaenghirunvattana et al" The prevalence (P) of the malignant nodule is 0.25 or 25% [10].…”

Verification of Mayo Clinic Formula to Determine Lung Cancer Probability among Patients Living in Tuberculosis Endemic Areas

“…[14][15][16][17] In our previous article, we reported nodules/ mass measuring 4.5-11 mm in our institution all caused by TB. 18 To further expound on the connection of lung nodule characteristics and diagnosis, we used the Mayo Clinic formula to find out if this is an effective and applicable tool in determining the probability of lung cancer in TB-endemic countries.…”