Structure of Bronchial Arteries in Lung Cancer

I: Site of origin.

Abstract

A study of the vascularization of lung cancer was made by 68 cases of selective bronchial arteriography and 67 cases of microangiography.
The degree and extent of vascularization of lung cancer is unpredictable and variable. It depends on site of origin, histologic type, stage of tumor growth, the way of invasion to the surrounding tissues and other factors such as radiation and anticancer chemotherapy effects.
In the present paper, the correlation between the structure of bronchial arteries and the site of origin was discussed. The cases of this study were classified into three groups clinically and pathologically according to the site of origin: They are central origin, intermediate and peripheral origin.
Tumors of central origin showed three types of selective bronchial arteriography. Two and three types were observed in tumors of intermediate and peripheral origin respectively.
1. Tumors of central origin. (22 cases)
Type 1. Bronchial stem artery was markedly dilatated and obstructed abruptly at the proximal margin of the tumor. An increased number of small abnormal vessels is distributed within the tumor as “tumor blush”. (8 cases)
Type 2. In atelectatic process, localized hypervascularity of the bronchial arteries made it possible to distinguish the tumor mass itself in the a telectatic lung parenchyma. (3 cases)
Type 3. Inflamatory vascular pattern -stands out exclusively, such as dilatation of the bronchial arteries and bronchopulmonary anastomosis. Bronchial a ngiogram gives no clue to the presence of underlying lung cancer. (6 cases)
2. Tumors of peripheral origin. (25 cases)
Type 1. Avascular pattern.
These tumors shows almost completely avascular. Few bronchial arteries coming into tumors were found angiographically. (2 cases)
Type 2. Hypovascular pattern.
Only a few broncial arteries were demonstrated aldng the bronchi and at the paroximal margin of the tumors. (14 cases)
Type 3. Hypervascular pattern
Hypervascularization of bronchial arteries was observed partially in the tumor, and these abnormal vessels radiated from this area. (6 cases)
3. Tumors of intermediate origin. (22 cases)
Type 1. Bronchial arteries are regularly distributed within the tumor. (13 cases)
Type 2. Bronchial angiographic pattern is same as peripheral type 3. (6 cases)
It seems that growing feature of tumors, especially characteristic differences due to the site of origin are well reflected in the selective bronchial arte riography.