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Vol.46 No.1 contents | Japanese/English |
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- The 31st Diagnostic Imaging Seminar -
The Meaning of Diagnostic Cytopathology for Peripheral Lung Lesions
Tomio Nakayama1, Takaichiro Suzuki1, Akemi Takenaka1, Sachiko Nagumo1, Junji Uchida1, Fumio Imamura1Osaka Medical Center for Cancer&Cardiovascular Diseases, Japan
Objective. To examine the meaning of preoperative cytopathology in the diagnosis of peripheral lung lesions. Method. We examined the meaning of diagnostic imaging and the diagnostic cytopathology by constructing a flowchart for the diagnosis of peripheral lung lesions from the viewpoint of medical decision making. Result. When a ground glass opacity (GGO) is seen on high-resolution CT (HRCT), the posttest probability of a positive test result does not increase much even if the cytopathologic diagnosis yields a positive result, because the pretest probability is high. If a negative result is obtained, the result lacks reliability because the lack of confirmation of accurate access to the lesion. Almost all clinicians recommend resection of suspicious lesions regardless of the result of cytopathological diagnosis. On the other hand, when a solid nodule is shown on HRCT, because the pretest probability of a positive test is low, the positive result of the cytopathologic diagnosis greatly improves the posttest probability. Conclusion. Diagnostic cytopathology is a poor method for the diagnosis of the GGO lesion. The clinician should select the method of diagnosis by appropriately judging a diagnostic imaging and clinical information. The endoscopy technician should also understand the appropriate method for the preparation of cytopathology.
key words: Cytopathology, Respiratory, Decision-making
JJLC 46 (1): 75-78, 2006
