Author of

• 14612

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  P2.06 - Poster Session/ Screening and Early Detection (ID 219)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14632

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    P2.06-020 - Comparison of Cytological Diagnosis Between Solitary and Semi-Solitary Lung Nodules in Biopsy Samples: Experience from a Single Academic Center (ID 769)

    09:30 - 09:30  |  Author(s): E. Gabrielson
    • Abstract

    Background:
    The recent large scale National Lung Cancer Screening Trial in the United States (NLST) demonstrated an increased detection of stage I lung cancers. This approach was associated with a 20% reduction of lung cancer-related deaths in the screening population. However, the current clinical guideline for the management of lung nodule is primarily based on studies of non-calcified solitary pulmonary nodules (SPN). Although several recent studies have addressed the issue of the management of semi-solitary and/or partially calcified lung nodules, the evidence-based study is still necessary. Clinically, the diagnosis of small pulmonary nodules involves the combination of radiological surveillance and the morphological examination of pulmonary cells, such as bronchoscopic sampling of the lesion, including bronchial brushing and/or transbronchial fine needle aspiration biopsy (TBNA) with or without ultrasound guidance. In this study, we correlated cytomorphological diagnoses of lung nodules with radiological characteristics, and compared them with findings of mediastinal lymph nodes (LN) fine needle aspiration (FNA) biopsy.
    
    Methods:
    A total of 300 lung and mediastinal LN cases over a one-year period were identified by a computer search, including 117 lung and 183 lymph nodes biopsies. All cases were divided into three categories: solitary, semi-solitary and partially calcified nodules/lesions according to radiographic image. The cytological diagnoses of all cases were correlated with radiographic findings.
    
    Results:
    In lung biopsies, the average sizes of the solitary, semi-solitary and calcified lesions were 1.952+/-2.225, 1.333+/-1.827, and 1.152+/-1.984 cm, whereas, in lymph nodes the average sizes of the solitary, semi-solitary and calcified lesions were 1.696+/-2.225, 0.909+/-1.041, and 2.788+/-3.371 cm. The cytological diagnosis was summarized in the table.

    Lesions	Lung (n=117)			Lymph node (n=183)
    	Malignant	Benign	Suspicious	Malignant	Benign	Suspicious
    Solitary (lung n=88) (LN n=156)	58 (65.9%)	23 (26.1%)	7 (8.0%)	136 (87.2%)	20 (12.8%)	0
    Semi-solitary (Lung n=23) (LN n=23)	8 (34.8%)	12 (52.2%)	3 (13.4%)	21 (91.3%)	2 (8.7%)	0
    Calcified (Lung n=6) (LN n=4)	2 (33.3%)	3 (50%)	1 (16.7%)	4 (100%)	0	0
    Total	68 (58.1%)	38 (32.5%)	11 (9.4%)	161 (88%)	22 (12%)	0

    
    
    Conclusion:
    In suspicious solitary and semi-solitary lung nodules, the malignancy was diagnosed as 65.9% and 34.8%, respectively. In suspicious solitary and semi-solitary lymph nodes, the malignancy was diagnosed as 87.2% and 91.3%, respectively. In lung lesions with partial calcifications (we only had very limited number of cases), approximately 50% were malignant lesions. In addition to radiological evaluation, the cytomorphological evaluation of semi-solitary and partially calcified nodules is still crucial for the accurate diagnosis and the appropriate clinical management of lung nodules patients.