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The changing radiographic presentation of bronchogenic carcinoma with reference to cell types
D Quinn1, A Gianlupi, S Broste
1Department of Pulmonary Medicine, Marshfield (Wis) Clinic 54449, USA.
Objective:
To analyze chest radiographic patterns of lung cancer at presentation by cell type. This current series is compared with historic published data.
Design:
Retrospective, using a tumor registry.
Setting:
Large, rural multispecialty clinic.
Patients:
Three hundred forty-five patients with newly diagnosed lung cancers presenting between October 1990 and August 1992.
Methods:
Radiographs were interpreted by two radiologists blinded to cell type. Our results were compared statistically to published data from Mayo Clinic patients in the 1950s and 1960s.
Results:
(1) Adenocarcinoma: Decreased presentation as a peripheral tumor in current series (49%) compared with historic control at Mayo (72%); (2) squamous cell: increased presentation as peripheral tumor in current series (43%) compared with historic control (31%); and (3) no statistically significant difference between adenocarcinoma (49%) and squamous (43%) for a presentation as a peripheral mass, or between adenocarcinoma (46%) and squamous (52%) for central origin in the current series of cases.
Conclusion:
As adenocarcinoma has increased in relative frequency among lung cancers, the percent of cases with peripheral primary tumors is decreased while central tumors have increased. Squamous carcinoma has had a relative increase in peripheral mass presentation. There is now no significant difference between these two cell types in percent presenting as a peripheral mass or central tumor on chest radiograph.