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Vol.39 No.1 contents | Japanese/English |
- Original Article -
Analysis of Reasons for Biopsy in Small Pulmonary Nodules Diagnosed by Thoracoscopic and Open-lung Biopsy
Hiroaki Nomori1, Hirotoshi Horio1, Gentarou Fuyuno2, Ryuichirou Kobayashi2, Shojiroh Morinaga3 and Keiichi Suemasu1Departments of Thoracic Surgery1, Medicine2, and Pathology3, Saiseikai Central Hospital
To increase the efficiency of lung cancer detection, we studied the reasons for thoracoscopic or open-lung biopsy in 122 patients with pulmonary nodules less than 30 mm in diameter. The roentgenological findings suggestive of malignancy were not significantly different in terms of the reason for biopsy between primary lung cancer (n=44) and inflammatory nodules (tuberculosis or non-specific inflammation) (n=40). The retrospective chest films taken as average of 14 months previously, demonstrated that the primary lung cancers showed enlargement of the nodules more frequently and appearance of new nodules less frequently than inflammatory nodules (P<0.05). Roentgenological findings suggestive of malignancy were seen in all primary lung cancer cases with N1 or N2 disease ... significantly more frequent than in the patients with N0 disease (P<0.05). We concluded thefollowings: (1) small lung nodules, which had a poor roentgenological findings of malignancy and showed appearance of new nodules in a review of X-ray films in the previous one or two years should be followed up by CT, rather than an immediate VATS biopsy because of the high possibility of inflammatory nodules; and (2) even if these are lung cancers, tumor stages are mostly T1N0M0, and it is uncommon for the tumor stage to advance after slight nodule enlargement during follow-up by CT.
key words: Small lung nodule, Lung cancer, Open-lung biopsy, Thoracoscopic biopsy
Received: August 11, 1998
Accepted: January 19, 1999
JJLC 39 (1): 35-41, 1999
