Bronchofiberscopic Localization and Findings of Roentgenologically Negative Lung Cancer

Abstract

This paper discusses the method of localization and the bronchoscopic findings of roentgenologically negative lung cancer detected by sputum cytology. Since the possibility of cancer of the upper respiratory tract exists, it must be carefully examined before bronchoscopy. Conspicuous findings, which are easily localized, include polypoid, nodal or flat elevation of the bronchial mucosa with an irregular surface and/or hypervascularity. Inconspicuous findings, which sometimes were difficult to localize, were small nodules, slight elevation or mucosal irregularity without elevation. Cases without abnormal bronchoscopic findings were classified into two categories. In one, the lesion is within the visible range of the bronchofiberscope, but the mucosal changes are so minimal that the lesion cannot be recognized. In the other, the lesion is located peripherally beyond the visible range of the bronchofiberscope, and is not detectable radiographically because of its minor size. Such cases should be examined carefully by systematic methods using washing cytology, brushing cytology and bronchial biopsy via bronchofiberscopy.