Chest X-rays and full lung tomograms in gynecologic malignancy

Four-hundred-seventy-one patients with gynecologic malignancy were studied. All of these had chest x-rays at the time of staging and 323 had concurrent full lung pleuridirectional tomography performed. In no instance were pulmonary parenchymal metastases identified by tomograms when the chest x-ray was negative and tomography led to more equivocal readings than did the chest x-ray. The current study indicates that there is extremely low diagnostic yield of full lung tomography in gynecologic malignancies. Full lung tomography was poor in assessing the presence of small pleural effusions. The yield of positive chest x-ray at varying follow-up times was also examined. The yield has been expressed by site of origin of the tumor as well as by stage at initial diagnosis. Some of these yields are quite high. There is a very poor prognosis when pulmonary findings become evident, regardless of the site of origin of the tumor. More than one half of the patients who develop pulmonary abnormalities will be dead within one year.