Diagnostic, Morphologic, and Histopathologic Correlates in Bronchogenic Carcinoma: Discussion (5)
The predilection of lung cancer for the upper lobes and a central location is well recognized and further confirmed by us. On the contrary, we did not find a prevalence of tumors arising from the right lung, as was generally reported. As mentioned, Ikeda reviewed the relationships between endoscopic findings, bronchial location, and three histopathologic subtypes. He found that SCs were often located centrally and visualized as endobronchial masses (201 cases out of 291). On the contrary, ACs, and less LCCs, were more often peripheral and showed mostly indirect findings, such as bronchial obstruction and compression, or no findings at all. These results are very close to ours. buy flovent inhaler
In conclusion, in addition to having contributed the descriptive data of a large series, we believe that we have demonstrated that for a given endoscopic finding, supposed to be malignant, and for a given bronchial location, there is a more likely cell type, and a more fruitful way to achieve the cytohistologic diagnosis. In practice, it seems to us not so important to perform a fixed number of both forceps and brush biopsies; rather, the best policy might be that of modulating their number in relation to the visible endobronchial abnormalities; for example, one could choose to make more forceps biopsies than brush passages in tumorlike lesions and vice versa in mucosal infiltration, while increasing the overall number of attempts in necrotic and compressive bronchial findings.