Study of diagnostic procedures and histopathology in primary malignancies in a tertiary care centre

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Original Article

Author Details : Ramakrishna Rachakonda*, A Aswani

Volume : 4, Issue : 2, Year : 2019

Article Page : 140-144

https://doi.org/10.18231/j.ijirm.2019.031

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Abstract

Background: Primary lung cancer is a leading cause of cancer related death all over the world. In Indian scenario lung cancer is increasingly diagnosed because of beedi and cigarette smoking and majority of times diagnosed in an inoperable stage resulting in poor prognosis.
Materials and Methods: In this study we have analysed the diagnostic modalities and histo-pathological analysis of the specimen obtained and correlated with the smoking status and age of the patients. A total of 113 patients having clinical and radiological profile suggestive of primary lung cancer are taken in to the study. Among them only 100 patients were diagnosed as malignancy by histopathological examination. For the confirmation of the diagnosis transthoracic needle aspiration biopsy with the help of ultrasonography and CT scan, bronchoscopic biopsy and bronchial washings, lymph node biopsy and pleural fluid analysis were undertaken.
Results: Positive specimens were obtained by TTNA in 54%, Bronchoscopic biopsy and washings in 30%, pleural fluid analysis in 12% and lymph node biopsy in 4% of patients. 82% are males and 18% are females. 82% are smokers and 18% are nonsmokers. 68 patients presented with mass lesions and 73% of them presented with a mass of >5cm in diameter. 27% presented as mass lesions less than 5cm in diameter. Smokers have more mass lesions and more N3 disease and the values are statistically significant. (p<.001). Squamous cell carcinoma is the commonest variety found (48%) followed by adenocarcinoma (34%), small cell carcinoma in 10% and others 8%. Increased age increased the prevalence of both squamous cell carcinoma and adenocarcinoma and the values are statistically significant at p-value of 0.05. Among males commonest cancer is squamous cell carcinoma (53.65%), followed by adenocarcinoma in 31.17%, small cell carcinoma in 7.31%. Among females both squamous cell and adenocarcinoma are equally present contributing to 33.33% each.

Summary and Conclusions: Primary lung cancer is a disease of older age. Smoking both active and passive or nonsmoking forms of tobacco are important aetiological factors. Predominat number of patients are males. Diagnosis of lung cancer requires a multi-disciplinary approach. Squamous cell carcinoma is more common among smokers. Adenocarcinoma is more common among nonsmokers. Among females both squamous and adenocarcinoma occured equally. All the cases of small cell carcinoma occured among smokers. As majority of the patients presented in late stages clinical outcome is poor. Prevention of smoking and mass campaigning against smoking in the rural areas can decrease the prevalence of lung cancer in India. Discouraging nonsmoking forms of tobacco is equally important.

Keywords: Squamous cell carcinoma, Adenocarcinoma, Small cell carcinoma, Smokers, Nonsmokers.

How to cite : Rachakonda R, Aswani A, Study of diagnostic procedures and histopathology in primary malignancies in a tertiary care centre. IP Indian J Immunol Respir Med 2019;4(2):140-144

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