Confirmation of histological type and select treatment metabolites to avoid unnecessary surgeries in patients with lung malignancies: A prospective observational study

Résumé

Background: Lung malignances is considered one of the mostly deadliest diseases in the present world. There are various types of method to investigate the malignance and the aim of the investigation is to confirm the histological type and select the treatment metabolites to avoid unnecessary surgeries. Objective: To confirm histological type and select treatment modalities to avoid unnecessary surgeries in patients with lung malignancies. Method: This prospective observational study was carried out department of medicine in Chittagong Medical College Hospital, Chittagong, Bangladesh. 50 patients with clinical and radiological evidence of suspected log went under sputum cytology for ahgnant cell and CT guided FNAC from suspected lung lesion. Results: Among the 50 patients most of the patients were 51-60 years old and the highest number of the (94 %) patients were male. Radiologically thirty-eight (38) patients presented with consolidation, six (6) with collapse and consolidation, three (3) with pleural effusion, three (3) with mediastinal enlargement underwent sputum for malignant cell and FNAC under CT guidance. Only three
(3) sputum samples reveal criteria of malignant cell and one was suspicious for malignant cell, another 46 samples were negative for malignant cell. FNAC specimens showed twenty-two (22) patients as squamous cell carcinoma, fourteen (14) patients as adenocarcinoma, eight (8) as small cell carcinoma and three (3) as poorly differentiated carcinoma. In case of three (3)
patients transthoracic FNAC under CT guidance could not be done due to deep seated and centrally placed lung lesion Conclusion: Sputum cytology for malignant cell is highly specific but insensitive. An adequate sample is prerequisite for successful detection of cancer cell in the sputum. FNAC under CT guidance can be used as accurate and safe method for the evaluation of lung carcinoma and it enables sub classification of Ca-lung in majority of the cases. The diagnostic yield is excellent and safe for the large, superficial and peripheral lesion.