title: The association of adenocarcinoma and hemosputum in pulmonary malignancies.
abstract: BACKGROUND
  Hemosputum was considered one of the popular symptoms of patients with centrally located carcinoma of the lung, especially squamous cell or small cell type. Recent studies reported a relative increase in adenocarcinoma compared with squamous cell carcinoma, especially in developed countries.
  
  
  OBJECTIVE
  The main purpose of this study was to determine the trend of histological type associated with the occurrence of hemosputum in patients with pulmonary malignancy.
  
  
  METHODS
  Retrospectively, the data from 1,050 patients with pulmonary malignancy who underwent bronchoendoscopic examination at our institution between May 1993 and May 2000 were analyzed.
  
  
  RESULTS
  One hundred and forty-nine out of 1,050 patients had hemosputum. There were 66 patients with adenocarcinoma, 55 with squamous cell carcinoma, 15 with small cell carcinoma, 5 with large cell carcinoma, 3 with other cell type carcinoma and 5 with metastatic carcinoma. On bronchoendoscopic examination, abnormal findings in the segmental or more proximal bronchi were found in 82 patients, including 36 with squamous cell carcinoma, 31 with adenocarcinoma, 12 with small cell carcinoma, 2 with large cell carcinoma and 1 with metastatic carcinoma. On the other hand, 67 patients were diagnosed with pulmonary malignancy in the subsegmental or more distal area, including 35 with adenocarcinoma, 19 with squamous cell carcinoma, 3 with small cell carcinoma, 3 with large cell carcinoma, 3 with other cell type carcinoma and 4 with metastatic carcinoma.
  
  
  CONCLUSIONS
  The most frequent histological type of malignancy with hemosputum was adenocarcinoma. The number of abnormalities in the peripheral region with hemosputum showed a progressive increase. The number of adenocarcinoma with hemosputum was increased in both central and peripheral regions.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan. m6640897@msic.med.osaka-cu.ac.jp
authors.forename: Setsuko
authors.initials: S
authors.lastname: Yamauchi
authors.forename: Shinzoh
authors.initials: S
authors.lastname: Kudoh
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kimura
authors.forename: Naruo
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Toru
authors.initials: T
authors.lastname: Mukohara
authors.forename: Kazuto
authors.initials: K
authors.lastname: Hirata
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000473:pathology; D001999:Bronchoscopy; D002277:Carcinoma / Q000473:pathology*; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013183:Sputum