Chest
Clinical InvestigationsOncologyFiberoptic Bronchoscopy in the Evaluation of Carcinoma Metastatic to the Lung
Section snippets
Methods
Since institution of FB at Walter Reed in 1970, duplicate bronchoscopy reports have been collected following every procedure. For this retrospective review, all FB reports for the 5-year period of 1987 to 1991 were evaluated.
Cases were selected for further review if the FB report indicated that the patient (1) had a history of extrapulmonary malignancy and presented with a new abnormality on chest radiograph or new pulmonary symptoms, (2) had a radiographic presentation suspicious for
Results
Between January 1, 1987 and December 31, 1991, 1,853 FBs were performed at Walter Reed (1,215 in men and 638 in women). One hundred sixty-six of the FBs (9 percent of the total) were performed in HIV-positive patients. One hundred eleven patients (6.0 percent) underwent FB for evaluation of extrathoracic malignancy metastatic to the thorax. Demographic information for this cohort is included in Table 1. These patients were divided into an abnormal FB group and a normal FB group. Bronchoscopic
Discussion
The lung is often involved when extrapulmonary malignancies metastasize, and FB is frequently performed as part of the patient's subsequent evaluation. We conducted this study to investigate which malignancies most commonly metastasize endobronchially, and what clinical and radiographic clues suggest abnormal endobronchial anatomy, so that a reasonable decision can be made as to when FB will be a potentially high-yield procedure. To our knowledge, this is the first study of this kind to be
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Supported by Department of Clinical Investigation Protocol 1756. The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized documents.
revision accepted May 14.