Relationshoip between Primary Lung Carcinoma Less Than 1.5cm in Diameter and the Associated Bronchi : Special Reference to Diagnostic Accuracy of Transbronchial Biopsy

Abstract

We evaluated the relationship between primary lung cancers less than 15mm in diameter and associated bronchi, and further investigated TBB yield. Subjects included 17 cases who underwent resection; 13 cases of adenocarcinoma, 2 cases of squamous cell carcinoma, 1 case of adenosquamous cell carcinoma, and 1 case of carcinoid. Resected lungs of 7 cases are inflated according to a modification of the Heizman's method, sliced axially at 1 mm thickness, imaged soft X-rays and correlated with preoperative 1-mm-slice HRCT and the pathological findings. The relationship between lesions and associated bronchi was classified into 4 types. We evaluated TBB results in relation to tumor size, type, order of associated bronchi, and visibility under X-ray fluoroscopy. Visible cases under X-ray fluoroscopy with Type I and II bronchus (positive bronchus sign) proximal to 6th order bronchi had better TBB yield.