The Uloga multidetektorske compjuterizovane tomografije (MDCT) u evaluaciji plućnih nodula sa histopatološkom korelacijom
Background: Lung cancer is the most common and lethal cancer around the world. Computed tomography (CT) is an integral imaging technique for staging the lung cancer. Aim of this study was to correlate the multidetector CT (MDCT) findings of lung nodule with histopathological examination, as well as to assess the diagnostic accuracy of MDCT in evaluation of suspected lung nodule.
Methods: One hundred patients with clinical or radiological suspicion of lung nodule referred for CT scan of thorax were included in the study. Histopathological analysis was performed. The location of the lesion was analysed and nodules were classified. Fine needle aspiration cytology (FNAC) was done with spinal needle under all aseptic precautions. The results obtained by MDCT were analysed and compared with histopathological findings done by CT guided FNAC.
Results: Average age of patients was 65 years, 25 % were females and 75 % were males. Among all the patients 66 % of lesions were located in right side lung and 34 % of lesions were left in location. Of all, 2 % patients had lesions less than 3 cm, 11 % patients had lesion between 3-4 cm, 19 % patients had lesion between 4–5 cm, 26 % patients had lesion between 5-7 cm and 42 % patients had lesion greater than 7 cm. Many of these patients also presented with enlarged lymph nodes, most commonly mediastinal (73 %) followed by subcarinal (51 %), hilar (44 %) and supraclavicular (4 %) lymph nodes. The most common histological findings of lung nodules analysis were adenocarcinoma (41 %). Among the 100 patients 58 % had lesions located peripherally while 42 % had central lesions. CT was a highly sensitive (95.45 %) and moderately specific (75 %) test and also had a high positive predictive value (96 %) to diagnose malignant lung nodule.
Conclusion: CT guided FNAC of lung nodule is a safe, minimal invasive proce- dure with a high diagnostic accuracy. The use of CT – guided FNAC in hilar and mediastinal nodules can avoid unnecessary exploratory surgery for staging and also diagnosis could be made with lesser cost.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017 Jan;67(1):7-30.
Batra P, Brown K, Aberle DR, Young DA, Steckel R. Imaging techniques in the evaluation of pulmonary parenchymal neoplasms. Chest 1992 Jan;101(1):239-43.
Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Health 2019 Jan 22;85(1):8. doi: 10.5334/aogh.2419.
Gangopadhyay M, Chakrabarti I, Ghosh N, Giri A. Computed tomography guided fine needle aspiration cytology of mass lesions of lung: Our experience. Indian J Med Paediatr Oncol 2011 Oct;32(4):192-6.
MeenaD, Singh Godara C, Saxena S, Khokhar H, Gupta A, Lal B. Role of multi detector computed tomography in evaluation and staging of bronchogenic carcinoma with its histopathological correlation. IOSR-JDMS 2019;18(5):28-35.
Ahmed Z, Israt T, Raza AM, Hossain SA, Shahidullah M. CT Guided FNAC of lung mass – a retrospective study of disease spectrum. J Histopath Cytopath 2018 Jul;2 (2):109- 113.
Gupta DK, Gupta S, Kukkar S. Radio pathological correlation of lung masses: a prospective study of 100 cases. IJMSE 2016;3(2):196-205.
Narayanaswamy I, Jayaram N, Ashwathappa S. Multidetector row computed tomography (MDCT) evaluation of bronchogenic carcinoma and histopathological correlation. J Med Imaging 2015;3(4):82-8.
Saha A, Kumar K, Choudhuri MK. Computed tomography-guided fine needle aspiration cytology of thoracic mass lesions: A study of 57 cases. J Cytol 2009 Apr;26(2):55-9.
Singh JP, Garg L, Setia V. Computed tomography (CT) guided transthoracic needle aspiration cytology in difficult thoracic mass lesions-not approachable by USG. Indian J Radiol Imaging 2004;14:395-400.
Mondal SK, Nag D, Das R, Mandal PK, Biswas PK, Osta M. Computed tomogram guided fine-needle aspiration cytology of lung mass with histological correlation: A study in Eastern India. South Asian J Cancer 2013 Jan;2(1):14-8.
Mukherjee S, Bandyopadhyay G, Bhattacharya A, Ghosh R, Barui G, Karmakar R. Computed tomography-guided fine needle aspiration cytology of solitary pulmonary nodules suspected to be bronchogenic carcinoma: Experience of a general hospital. J Cytol 2010 Jan;27(1):8-11.
Gadodiya K, Patil RN, Kumbhalkar D, Raut WK. Computed tomography guided fine needle aspiration cytology of lung and mediastinal lesions. IJCMR 2019;6(2):B7-B12. DOI: http://dx.doi.org/ 10.21276/ ijcmr.2019.6.2.17.
Saket RK, Divyashree. Role of multi-detector computed tomography imaging in patients with clinically suspected
lung cancer in Kumaun Region of Uttarakhand (India) JM-SCR 2016 Aug;04(08):11839-49.
Rawat J, Sindhwani G, Gaur D, Dua R, Saini S. Clinico-pathological profile of lung cancer in Uttarakhand. Lung India 2009 Jul;26(3):74-6.
Adaikkalavan C, Sajitha K, Verghese J, Varghese AE. Role of computed tomography in diagnosis of bronchogenic carcinoma with histopathological correlation. JMSCR 2017;5(6):23500-9.
Biswas P, Datta A, De A, Sinha LK. Pulmonary mass lesions: CT scan diagnostic-impressions and FNAC diagnoses a correlative study. Int J Med Res Rev 2016;4(6):1052-6.
Yadav D, Yadav N, Goyal R, Romana M. Role of multidetector computed tomography in evaluation of suspected bronchogenic carcinoma. Int J Res Med Sci 2016;4:829-35.
Shah D, Shastri M, Patel D, Diwanji N, Desai E, Chitara M, et al. Diagnosis and staging of lung carcinoma with CT scan and its histopathological correlation. Int J Res Med Sci 2017;5:2346-52.
Modi M, Nilkanthe R, Kikani A, Trivedi P, Trivedi M, Modi V, et al. Histopathological and CT imaging correlation of various primary lung carcinoma. IOSR-JDMS 2016 Mar;15(3):104-10.
Babu S, Kumar S. Multidetector CT evaluation of neoplastic lung lesions with image guided transthoracic tissue sampling. IOSR-JDMS 2016 Feb;15(2):50-3.
Krishnamurthy A, Vijayalakshmi R, Gadigi V, Ranganathan R, Sagar TG. The relevance of "Nonsmoking-associat- ed lung cancer" in India: a single-centre experience. Indian J Cancer 2012 Jan-Mar;49(1):82-8.
Arora VK, Seetharaman ML, Ramkumar S. Bronchogenic carcinoma; Clinicopathological pattern in south Indian population. Lung India 1990;7:133-8.