Virtual Bronchoscopy as the Guide for Fiberoptic Bronchoscopy in Evaluating Tracheobronchial Disorders in the Bronchogenic Carcinoma

Fiberoptic bronchoscopy (FOB) is one of the important modalities in helping to uphold the diagnosis and stadium of bronchogenic carcinoma. However, FOB has some limitations, namely invasive, time-consuming, requiring sedation, intolerable in patients who are critically ill, and difficult to evaluate distal airway side of severe stenosis. To identify the imaging capability of virtual bronchoscopy (VB) examinations in evaluating abnormalities in the tracheobronchial in bronchogenic carcinoma. Observational study with total sampling. Data was obtained from the histopathologic with diagnosis of bronchogenic carcinoma in 1 year. Retrospectively, the data were obtained from the archives of thoracic CT examinations in Radiology and FOB examination in Lung Operating Room. The variables assessed were the finding of mass of endobronchial based on its location, the main bronchi constriction, lobar bronchi constriction, segmental bronchi constriction, and compression/tracheal deformity. The results of VB were examined by three radiologists independently and were then compared with the results of FOB. The observation results of VB and FOB were used to analyse the degree of conformity. There is a low level of agreement on the finding of endobronchial mass, lobar bronchi and segmental bronchi constriction, sufficient level of agreement on the main bronchial constriction finding. VB has a limited capacity to evaluate abnormalities of the tracheobronchial compared with FOB, but VB has an advantage in evaluating the patency of the distal airway of severe obstruction.

Adenocarcinoma lung presenting with meningeal carcinomatosis

Meningeal infiltration by malignant metastasis process without brain parenchymal involvement is very unusual event in patients with bronchogenic carcinoma. This manuscript describes a case of adenocarcinoma right lung in a 48-year old male having persistent headache. The cerebrospinal fluid cytology revealed the presence of metastatic deposits of adenocarcinoma lung that confirmed the diagnosis of meningeal carcinomatosis.

CLIVAL METASTASES CAUSING DIPLOPIA - AN UNUSUAL PRESENTATION OF BRONCHOGENIC CARCINOMA

Lung Cancer is the most common cancer worldwide with most cases being detected at Stage IV. Among these, metastases to the clivus are rare with only very few cases reported in literature. The long course of the abducent nerve in relation to the clivus, makes it susceptible for metastases and subsequent lateral rectus palsy. We present the case of a heavy smoker, 64 years old man who presented with headache and diplopia, on evaluation diagnosed as bronchogenic carcinoma with clival metastases on magnetic resonance imaging(MRI).

HOARSENESS OF VOICE: ETIOLOGICAL SPECTRUM

Background: To evaluate the etiological factors of hoarness Methods: The present study has been carried out in 100 cases of hoarseness were included. Patient with laryngeal and hypopharyngeal malignancy & up to 15 year of age excluded from the study. Results: In the present series bronchogenic carcinoma is the most common etiological factor causing vocal cord paralysis and second is thyroid surgery and third is tuberculosis of lung Conclusion: Voice production is a complex mechanism, involving the muscles of pharynx, palate, tongue, nose and lips. A proper protocol is necessary for identifying the factors responsible for vocal fold paralysis which would help in managing the condition more effectively. Keywords: Vocal cord, Carcinoma, Paralysis.

Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Background Lung cancer is the most common among all kinds of cancers. It still constitutes the leading cause of cancer-related deaths worldwide, even with major advancements in prevention and treatments available. More than 85% of the cases are of non-small cell lung cancer (NSCLC), while less than 15% are of small cell lung cancers (SCLCs). Patients and methods This is a prospective study of 20 patients confirmed histopathologically to have bronchogenic carcinoma, who came for assessment of therapeutic response. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after therapy. Semiquantitative assessment was used to determine maximum standardized uptake value (SUVmax). Treatment response evaluation was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results Comparison of the pre- and post-treatment SUVmax in the responder and non-responder groups revealed that the post-treatment SUV was significantly lower than the baseline SUV in the responder group (P = 0.008). The responder post-treatment SUV and ∆ SUV were significantly lower than the non-responder values (P = 0.014 and 0.0004 respectively). The optimum threshold values of post-treatment SUV and ∆ SUV threshold defined by the receiver operating characteristic (ROC) curve analysis were ≤ 8 and ≤ −48.3 respectively. The sensitivity, specificity, PPV, NPV, and AUC of post-treatment SUV for predicting tumor response were 100%, 66.67%, 66.7%, 100%, and 0.833 respectively. The sensitivity, specificity, PPV, NPV, and AUC of ∆ SUV for predicting tumor response were 100%, 91.67%, 88.9%, 100%, and 0.979% respectively. Conclusion PET/CT proved itself as useful, efficient, and reliable tool in follow-up of lung cancer patients as it gives an early and accurate metabolic response assessment before any CT changes, leading to early modification of therapy or confirmation of its efficiency.

Immunohistochemical and Histopathological Study of Anaplastic Lymphoma Kinase and Tyrosine-kinase Receptor Expression in Bronchogenic Carcinoma

BACKGROUND: Adenocarcinoma of the lung is the most common tumor type of primary lung cancer and is characterized by heterogeneity on the molecular, clinical, and pathological levels. The presence of an anaplastic lymphoma kinase (ALK) fusion oncogene defines a molecular subset of non-small cell lung cancer with distinct clinical and pathologic features. Furthermore, the tyrosine-kinase receptor (C-kit) is considered to be expressed in various solid tumors, including carcinomas of the lung. AIM: This study aims to correlate immunohistochemical (IHC) expression of ALK and C-kit with pathological features of lung carcinoma and to correlate IHC expression of ALK with IHC expression of C-kit in lung carcinoma. MATERIALS AND METHODS: The material of this study consists of paraffin blocks of 60 cases of patients with bronchogenic carcinoma, IHC staining with ALK and C-kit then analysis of immunoreactivity scoring was done. RESULTS: As regards ALK expression, 3 (5%) cases showed positive expression of ALK and 57 (95%) cases showed negative expression of ALK with no statistically significant correlation between the ALK expression and the histopathological type. While C-kit expression, 4 (6.7%) cases showed positive expression and 56 (93.3%) cases showed negative expression of C-kit with statistically significant correlation between the C-kit expression and the histopathological type. CONCLUSION: There is an association between expression of c-kit and tumor histological type in lung carcinoma. Expression was notably significant among adenocarcinomas and small cell carcinomas.