The changing radiographic presentation of bronchogenic carcinoma with reference to cell types.

Abstract

OBJECTIVE: To analyze chest radiographic patterns of lung cancer at presentation by cell type. This current series is compared with historic published data. DESIGN: Retrospective, using a tumor registry. SETTING: Large, rural multispecialty clinic. PATIENTS: Three hundred forty-five patients with newly diagnosed lung cancers presenting between October 1990 and August 1992. METHODS: Radiographs were interpreted by two radiologists blinded to cell type. Our results were compared statistically to published data from Mayo Clinic patients in the 1950s and 1960s. RESULTS: (1) Adenocarcinoma: Decreased presentation as a peripheral tumor in current series (49%) compared with historic control at Mayo (72%); (2) squamous cell: increased presentation as peripheral tumor in current series (43%) compared with historic control (31%); and (3) no statistically significant difference between adenocarcinoma (49%) and squamous (43%) for a presentation as a peripheral mass, or between adenocarcinoma (46%) and squamous (52%) for central origin in the current series of cases. CONCLUSION: As adenocarcinoma has increased in relative frequency among lung cancers, the percent of cases with peripheral primary tumors is decreased while central tumors have increased. Squamous carcinoma has had a relative increase in peripheral mass presentation. There is now no significant difference between these two cell types in percent presenting as a peripheral mass or central tumor on chest radiograph.