Localization of Early Stage and Advanced Lung Cancer by Fiberoptic Bronchoscopy : with Paticular Regard to Vascular Patterns

Abstract

At present there is not internationally recognized classification of bronchoscopic findings (in lung cancer). In the Classification of Bronchoscopic Findings (1979) of the Japanise Association of Lung Cancer, the only reference to the vascular patterns in areas of cancer invasion is the simple term "Vascular engorgement". Since the types of vascular patterns observed through the bronchoscope vary according to the histologic type, site of origin and extent of disease (type of development), the authers set out to study these patterns. In the normal bronchus microvessels are observedistributed like bronchus. In areas of epithelial invasion in squamous cell carcinoma since the membrane loses its transparency it is hard to recognize the presence of vessels. However in areas in which invasion extends to the subepithelial tissue new vessels appear growing in irregular spiral patterns with varying degrees of distention and occasional rupture. In adenocarcinoma and small cell carcinoma which show a tendency to grow submucosally the vessels can be seen extending from the normal mucosa to the surface of the invasion, in many cases with distention and irregular patterns.