Small Bronchogenic Carcinomas Presenting as Solitary Pulmonary Nodules

Gaeta, Michele; Russi, Elvio; Spada, Francesco La; Barone, Mario; Casablanca, G; Pandolfo, I

doi:10.1378/chest.102.4.1167

Cited by 26 publications

(14 citation statements)

References 14 publications

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“…In the current study, based on Gaeta et al's [2] conclusion mentioned above and also based on Popovich et al's [15] report supporting performance of bronchoscopic multiple biopsies in peripheral carcinomas, we investigated the contribution of combining third-to fifth-order CT bronchus sign and bronchoscopic multiple diagnostic procedures (BMDPs) to the diagnostic yield in SPNMs highly suspected of primary pulmonary carcinoma.…”

Section: Introductionmentioning

confidence: 96%

“…CT BS can be utilized as a guiding sign to direct diagnostic procedures in solitary pulmonary nodules or masses (SPNMs) [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…No well-established, standard strategy specifying the role of either transbronchial or percutaneous approach has yet been constituted; some authors recommend their sequential integrated use [7,9,10,13] whereas others advocate routine evaluation with thin-section CT to determine the presence/absence, order and type of BS that will be decisive in making a choice between the two approaches [1][2][3][4]. Gaeta et al [2] reported that transbronchial approach was significantly more yielding and safer in SPNs with third-to fifth-order BS than those with a more peripheral or no BS in which transthoracic procedures conversely proved to provide higher yields and less complications.…”

Section: Introductionmentioning

confidence: 99%

“…Gaeta et al [2] reported that transbronchial approach was significantly more yielding and safer in SPNs with third-to fifth-order BS than those with a more peripheral or no BS in which transthoracic procedures conversely proved to provide higher yields and less complications.…”

Section: Introductionmentioning

confidence: 99%

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CT Bronchus Sign-Guided Bronchoscopic Multiple Diagnostic Procedures in Carcinomatous Solitary Pulmonary Nodules and Masses

et al. 1998

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CT bronchus sign (BS) designates a bronchus leading directly to a peripheral pulmonary lesion. The objective of this investigation is to determine the contribution of BS-guided bronchoscopic multiple diagnostic procedures (BMDPs) to the diagnostic yield of solitary nodules or masses (SPNMs) suspected of pulmonary carcinoma (PC). A prospective study was carried out in 92 patients with a 2–5 cm diameter SPNM at the level of third to fifth bronchial branching and without endobronchial tumors. Within 10 days after 2-mm CT scans were done, in each of 92, bronchial washing (BW), brushing (BR), transbronchial needle aspiration (TBNA) and transbronchial lung biopsy (TBB) were performed respectively, via fiberoptic bronchoscopy (FB) under fluoroscopic guidance. In 40 (82%) of 49 with BS and in 19 (44%) of 43 without BS, FB established the diagnosis (p < 0.01). In 84 cases of PC, BW, BR, TBNA and TBB provided the diagnostic yields of 4% (3), 26% (22), 57% (48) and 49% (41), respectively; the combined yield reached 68% (57). A metastasis and a tuberculoma were diagnosed exclusively by TBB, and TBNA, respectively. All differences of diagnostic yield except that between TBNA and TBB (p > 0.05) were determined to be significant (p < 0.05). Thoracotomy verified diagnosis in 48 of 59 cases diagnosed and 19 of 33 undiagnosed by FB, and various tissue biopsies or clinical follow-up in 11 diagnosed and 14 undiagnosed by FB. The above data suggest that in the diagnosis of PC as a SPNM at the level of third–fifth bronchial branching, combining the guidance of CT BS, and BMDPs under fluoroscopic guidance can increase the yield considerably.

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Section: Introductionmentioning

confidence: 96%

“…CT BS can be utilized as a guiding sign to direct diagnostic procedures in solitary pulmonary nodules or masses (SPNMs) [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

CT Bronchus Sign-Guided Bronchoscopic Multiple Diagnostic Procedures in Carcinomatous Solitary Pulmonary Nodules and Masses

et al. 1998

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“…Many studies have analyzed the factors that affect the diagnostic performance of flexible bronchoscopy in the evaluation of peripheral lesions. These studies have demonstrated that the size, presence of the bronchus sign, and nature of the lesion are determinants of the diagnostic yield in bronchoscopy when evaluating peripheral lung lesions [7][8][9] . However, few studies have reported the diagnostic performance of conventional bronchoscopy without fluoroscopic guidance.…”

Section: Introductionmentioning

confidence: 99%

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Lee

Kang

Ban

et al. 2016

Chest

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Background:We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], p<0.001 and OR, 4.91; 95% CI, p=0.002). Conclusion:The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

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