Korean J Radiol.  2002 Dec;3(4):229-234. 10.3348/kjr.2002.3.4.229.

Superficial Endobronchial Lung Cancer: Radiologic-Pathologic Correlation

• Han NJ
• Song KS
• Lee KH
• Seo JB
• Lee JS
• Lim TH
• Kang GH

• KMID: 1118789
• DOI: http://doi.org/10.3348/kjr.2002.3.4.229

Abstract

OBJECTIVE
To analyze the plain chest radiographic and CT findings of superficial endobronchial lung cancer and to correlate these with the findings of histopathology. MATERIALS AND METHODS: This study involved 19 consecutive patients with pathologically proven lung cancer confined to the bronchial wall. Chest radiographs and CT scans were reviewed for the presence of parenchymal abnormalities, endobronchial nodules, bronchial obstruction, and bronchial wall thickening and stenosis. The CT and histopathologic findings were compared. RESULTS: Sixteen of the 19 patients had abnormal chest radiographic findings, while in 15 (79%), CT revealed bronchial abnormalities: an endobronchial nodule in seven, bronchial obstruction in five, and bronchial wall thickening and stenosis in three. Histopathologically, the lesions appeared as endobronchial nodules in 11 patients, irregular thickening of the bronchial wall in six, elevated mucosa in one, and carcinoma in situ in one. CONCLUSION: CT helps detect superficial endobronchial lung cancer in 79% of these patients, though there is some disagreement between the CT findings and the pathologic pattern of bronchial lesions. Although nonspecific, findings of bronchial obstruction or bronchial wall thickening and stenosis should not be overlooked, and if clinically necessary, bronchoscopy should be performed.

Keyword

Lung, radiography; Lung neoplasm, CT

MeSH Terms

Carcinoma in Situ/pathology/radiography
Carcinoma, Squamous Cell/pathology/*radiography
Human
Lung/pathology
Lung Neoplasms/pathology/*radiography
Male
Middle Age
Neoplasm Invasiveness
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Diagram showing the distribution of superficial endobronchial lung cancer according to its location. Numbers in parentheses indicate the number of endobronchial lesions identified at CT (the numerator) and the number of lesions histopathologically confirmed (the denominator).

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  Fig. 2 A 66-year-old man with chronic cough. A, B. Chest radiographs showing segmental consolidation in the superior segment of the right lower lobe. C. CT scans (10-mm-thick sections) demonstrate an endobronchial nodule at the distal bronchus intermedius (arrow) and consolidation in the superior segment of the right lower lobe. D. Photomicrography of pathologic specimen depicts an endobronchial nodule (arrows) and invasion of the full thickness of the bronchial wall (arrowhead) by the carcinoma (original magnification, ×100; hematoxylin-eosin staining).

• 

  Fig. 3 A 59-year-old man with blood-tinged sputum. A, B. Chest radiographs show segmental collapse in the anterior segment of the left upper lobe. C. CT scans (10-mm-thickness) depict bronchial obstruction and segmental atelectasis of the anterior segment of the left upper lobe. D. Photomicrography of pathologic specimen shows a polypoid mass in the anterior segmental bronchus of the left upper lobe (arrows), its invasive component extending through the full thickness of the bronchial wall (not shown here) (original magnification, ×400; hematoxylin-eosin staining).

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  Fig. 4 A 61-year-old man with blood-tinged sputum and weight loss. A. Chest radiograph reveals no abnormality. B. CT scan demonstrates patent right upper lobar bronchus with no endobronchial abnormality. C. Pathologic specimen depicts mucosal irregularity in the right upper lobar bronchus (arrows), and intramucosal invasion (arrowheads) (original magnification, ×40; hematoxylin-eosin staining).

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