A combined imagistic and morphological approach of lung tumors: study on 64 cases

Lung cancer is currently one of the major health problems, being considered one of the most common causes of death by cancer worldwide. That is why establishing as early as possible a diagnosis in order to start an appropriate therapy still a challenge. The studied group consisted of 64 patients who were investigated following the next algorithm: chest X-ray, bronchoscopy, guided bronchial brushing and/or bronchoalveolar lavage followed by cytological examination and if possible, endobronchial biopsy followed by histopathological examination. Patients were usually men, aged over 60 years coming from an urban area, smokers and with symptoms evoking the presence of neoplasia. Tumors presented as large tumoral masses, placed centrally and with obvious local spread, protruding or pushing intraluminally with subsequent bronchial stenosis, usually complicated with ulceration and bleeding, which proved to be, when histopathological examination was possible, firstly squamous carcinomas and then small cell carcinomas. The imagistic investigation in conjunction with the cytological evaluation can establish the diagnosis of malignancy of centrally located lung tumors in almost 80% of cases. The diagnosis can be improved by increasing the number of biopsy sampling and/or by the immunohistochemical marking of the cytological samples.