Abstract
We previously reported that selective brushing of all bronchial branches was very useful for detection of the location of cancer in patients with positive sputum cytology. However, it is difficult to detect the location of cancer in some cases using this examination. From 1986 to 1989, in 11 of 118 cases with positive sputum cytology, bronchofiberscopy had to be performed three times or more in order to detect the location of the cancer. The clinical courses, bronchoscopic findings, radiologic findings, and cytologic findings of these 11 cases were analysed. Two of these 11 cases had cancer lesions in the upper respiratory tract, 1 had a lung cancer lesion within the field of bronchoscopic visibility, and the remaining 8 had lung cancer lesions beyond the field of bronchoscopic visibility. Five of the 8 cases had no abnormal radiologic findings, but an abnormal shadow was detected with chest CT in each of remaining 3 cases, retrospectively. In two of these 3 cases an abnormal shadow abutted upon the mediastinal structures. In cases with positive sputum cytology in which it is difficult to detect the location of cancer, diagnosis requires a thorough examination of the upper respiratory tract and of the lung heyond the field of bronchoscopic visibility.
