[Fiber bronchoscopy in lung cancer: relationship between radiology, endoscopy, histology and diagnostic value in a series of 1801 cases].

A retrospective analysis of 1,801 patients with primary pulmonary neoplasm diagnosed by fiber bronchoscopy between 1977 and 1992 was carried out in order to determine the relation between chest X-rays and endoscopic and histological findings, as well as to assess the diagnostic usefulness of the various endoscopic techniques used. Central tumors numbered 1,598 and peripheral ones 203. The largest tissue classification was squamous (39%) and the most common X-ray finding was pulmonary mass (40%). Endoscopy showed neoplastic infiltration in 49% of the cases and endobronchial tumor in 27%. X-rays showing pulmonary mass, hilar involvement and atelectasis were more often associated with infiltration, tumor and necrosis and with a small-cell tissue type. Bronchial biopsy gave the best diagnostic results in these cases. In cases of solitary pulmonary nodule and pleural effusion, on the other hand, normal endoscopic results with non-specific changes or extrapulmonary involvement, predominated, with adenocarcinoma and non-small cell tissue types. Transbronchial biopsy, especially with radioscopic monitoring, was most useful in these cases. We conclude that chest X-rays and endoscopic results can be used to predict the most likely tissue type in lung cancer and that they can serve as guides for the choice of diagnostic technique.