Clinical relevance of sputum cytology and chest X-ray in patients with suspected lung tumors.
OBJECTIVE
To review diagnostic procedures, therapeutic modalities, and follow-up methods in patients with suspected lung tumors.


METHODS
We retrospectively examined 70 patients who underwent a complete medical checkup because they had been positive for sputum cytology and had presented no chest X-ray findings for the 10-year period between 1994 and 2004. To make a diagnosis, we conducted the first complete medical checkup that included chest X-ray, sputum cytology, chest computed tomography (CT), and bronchoscopy. In the case that no diagnosis could be made, we repeated the chest X-ray and sputum cytology every 3 to 6 months and additionally conducted chest CT and bronchoscopy according to abnormal findings.


RESULTS
Among 70 patients, there were 36 and 13 who were diagnosed during the first complete medical checkup and follow-up, respectively, 13 who remained undiagnosed, and eight for whom follow-up was discontinued. Among the 49 diagnosed patients, 40, 8, and 1 patient had lung cancer, upper respiratory tract carcinoma (URTC), and esophageal carcinoma (EC), respectively. Among the 40 patients with lung cancer, 34 had a stage 0 or I tumor and 15 were radically treatable by photodynamic therapy and endobronchial irradiation. Nine among 11 patients whose lung cancer was detected during follow-up had a stage 0 or IA tumor.


CONCLUSIONS
Not only lung cancer but also URTC and EC were successfully detected in patients who were positive for sputum cytology and presented negative chest X-ray. Radical treatment was possible in 38 (76%) of 50 diagnosed patients, thus indicating the importance of follow-up through these procedures.
Sumitani
Mitsuhiro
M
Department of Respiratory Medicine, Osaka City General Hospital, Osaka, Japan. sumytany@nifty.com
Takifuji
Nobuhide
N
Nanjyo
Shigeki
S
Imahashi
Yumiko
Y
Kiyota
Hidemi
H
Takeda
Koji
K
Yamamoto
Ryoji
R
Tada
Hirohito
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D042241:Early Diagnosis; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008400:Mass Chest X-Ray; D008875:Middle Aged; D010778:Photochemotherapy; D012189:Retrospective Studies; D013183:Sputum / Q000166:cytology*; D014057:Tomography, X-Ray Computed