The changing radiographic presentation of bronchogenic carcinoma with reference to cell types.

OBJECTIVE

To analyze chest radiographic patterns of lung cancer at presentation by cell type. This current series is compared with historic published data.

DESIGN

Retrospective, using a tumor registry.

SETTING

Large, rural multispecialty clinic.

PATIENTS

Three hundred forty-five patients with newly diagnosed lung cancers presenting between October 1990 and August 1992.

METHODS

Radiographs were interpreted by two radiologists blinded to cell type. Our results were compared statistically to published data from Mayo Clinic patients in the 1950s and 1960s.

RESULTS

(1) Adenocarcinoma: Decreased presentation as a peripheral tumor in current series (49%) compared with historic control at Mayo (72%); (2) squamous cell: increased presentation as peripheral tumor in current series (43%) compared with historic control (31%); and (3) no statistically significant difference between adenocarcinoma (49%) and squamous (43%) for a presentation as a peripheral mass, or between adenocarcinoma (46%) and squamous (52%) for central origin in the current series of cases.

CONCLUSION

As adenocarcinoma has increased in relative frequency among lung cancers, the percent of cases with peripheral primary tumors is decreased while central tumors have increased. Squamous carcinoma has had a relative increase in peripheral mass presentation. There is now no significant difference between these two cell types in percent presenting as a peripheral mass or central tumor on chest radiograph.