ABSTRACTS SELECTED IN NALCCON 2013 , SRINAGAR
Unsual clinical and radiological presentation in elderly: Always rule out malignancy first
Authors- Prof. Dr A.P. Kansal, Parul Mrigpuri, Amitesh Gupta, Naresh Kumar, Sudesh Kumari, Shiyas Mohammed
Dept. of Chest and Tuberculosis, Govt. Medical College, Patiala, Punjab
INTRODUCTION
Lung cancer is the second most frequently diagnosed cancer in both men and women and is the leading cause of cancer related mortality. A chest x-ray is usually the first test performed to evaluate any concerns based on a careful history and physical examination. The most common radiological manifestation in lung cancer is solitary or multiple pulmonary nodules.
AIMS AND OBJECTIVE
We are presenting a series of 12 cases which presented to us with different history, clinical and chest x-ray presentations and were ultimately proved to have malignancy. These patients were already on some form of treatment to which there was no response. The diagnosis made from outside was not correlating with their age, clinical and radiological findings.
METHODS
This study involved 12 patients who presented to us with complaints pertaining to chest with a mean age of 60 years and having unusual chest x ray finding. These patients were admitted in ward and thorough investigative work up was done to reach at the most accurate diagnosis.
RESULTS
10 (83.3%) were males and 2 (16.7%) were females. History of smoking was present in 4(33.3%) of them. 3 (25%) of them were having a long standing chest wall mass which was misinterpreted as lipoma. After CT chest it was seen that those were actually the extension into the chest wall of the mass in the lung. 5 (41.7%) were having unilateral pleural effusion. Most of the patients were already on anti-tuberculosis treatment on X-ray chest and pleural fluid basis with minimal or no improvement in their clinical condition. CT chest and then CT guided FNAC proved the diagnosis in each case and the treatment was amended accordingly.
CONCLUSION
In developing countries, high prevalence along with clinical and radiological similarities of PTB (pulmonary tuberculosis) with lung cancer often may mislead clinicians to diagnose lung cancer as TB. This leads to unnecessary delay in the diagnosis. One should not have tubular vision while managing any patient with long standing CXR lesion not improving with ATT specially in elderly and should always order for other investigations to rule out the possibility of lung cancer.
Utility of Computed Tomography Guided Percutaneous Transthoracic Fine Needle Aspiration Cytology in Different Lung Lesions
Authors- Prof. Dr. A.P. Kansal, Amitesh Gupta, Parul Mrigpuri, Komaldeep Kaur, Don Gregory Mascarenhas
Dept. of Chest and Tuberculosis, Govt. Medical College, Patiala, Punjab
INTRODUCTION
Percutaneous transthoracic fine needle aspiration cytology is a well established diagnostic method used in the cytological evaluation of both neoplastic and inflammatory conditions of lung . CT offers detailed anatomical display of all thoracic structures and CT guided FNAC of suspicious lung masses is widely accepted simple diagnostic method of relatively low cost used to establish diagnosis of lung and chest lesions.
OBJECTIVE AND METHOD
A hospital based descriptive study is being done to know the pathological spectrum of thoracic lesions obtained from computed tomography guided percutaneous transthoracic fine needle aspiration.
RESULTS
The clinical, radiological and cytological data of 100 patients were studied who underwent CT guided FNAC chest from July, 2010 to July, 2012 at department of pulmonary medicine, Govt. medical college, Patiala.
Cytological examination showed that 36 cases were malignant, 54 cases were non malignant and in 10 cases diagnosis was inconclusive. Provisional diagnosis based on radiological and clinical findings were 54 and 46 cases of malignant and non malignant pathology respectively.
Post procedure complications were pneumothorax in three cases which was self resolving did not require any intervention and hemoptysis in two cases which also did not require any active management.
CONCLUSION
CT guided fine needle aspiration cytology (FNAC) is a simple and safe procedure with high diagnostic accuracy for the diagnosis and cell typing of lung lesions especially where this facility exists. Though complications are rare, pneumothorax, perilesional hemorrhage, hemoptysis and chest pain are occasionally encountered, but rarely require active management.
Authors- Prof. Dr. A.P. Kansal, Amitesh Gupta, Parul Mrigpuri, Komaldeep Kaur, Don Gregory Mascarenhas
Dept. of Chest and Tuberculosis, Govt. Medical College, Patiala, Punjab
INTRODUCTION
Percutaneous transthoracic fine needle aspiration cytology is a well established diagnostic method used in the cytological evaluation of both neoplastic and inflammatory conditions of lung . CT offers detailed anatomical display of all thoracic structures and CT guided FNAC of suspicious lung masses is widely accepted simple diagnostic method of relatively low cost used to establish diagnosis of lung and chest lesions.
OBJECTIVE AND METHOD
A hospital based descriptive study is being done to know the pathological spectrum of thoracic lesions obtained from computed tomography guided percutaneous transthoracic fine needle aspiration.
RESULTS
The clinical, radiological and cytological data of 100 patients were studied who underwent CT guided FNAC chest from July, 2010 to July, 2012 at department of pulmonary medicine, Govt. medical college, Patiala.
Cytological examination showed that 36 cases were malignant, 54 cases were non malignant and in 10 cases diagnosis was inconclusive. Provisional diagnosis based on radiological and clinical findings were 54 and 46 cases of malignant and non malignant pathology respectively.
Post procedure complications were pneumothorax in three cases which was self resolving did not require any intervention and hemoptysis in two cases which also did not require any active management.
CONCLUSION
CT guided fine needle aspiration cytology (FNAC) is a simple and safe procedure with high diagnostic accuracy for the diagnosis and cell typing of lung lesions especially where this facility exists. Though complications are rare, pneumothorax, perilesional hemorrhage, hemoptysis and chest pain are occasionally encountered, but rarely require active management.