A Study of Visible Malignant Bronchial Tumors

During 16 years (1951-1966), bronchoscopy was performed on 280 cases with malignant bronchopulumonary growths, which were diagnosed clinically by cytologic and bioptic findings or confirmed pathologically on resected or necropsied bronchopulmonary specimens.In 101 out of these 280 cases examined, the malignant growths were found bronchoscopically and these visible tumors were classifted in following four types from the bronchologic, roentgenologic and pathologic point of view:I) Localized primary bronchogenic cancer and sarcoma (Localized Type) .. 20 casesII) Invasive primary bronchogenic cancer (Invasive Type) … 58 casesIII) Bronchial tumorous invasion caused by parabronchial lymphnode metastasis of the primary bronchogenic cancer (Lymphnode Metastatic Type) … 21 casesIV) Bronchial tumorous invasion caused by pulmonary or parabronchial lymphnode metastasis of the primary extrathoracic malignant growths (Extrathoracic Type) … 2 casesIn the majority of the cases with the bronchial tumors of each type, their roentgenologic findings of the chest were characterized by the unilateral, lobar or segmental opacity. However, in some cases, bipolar or cavitary shadow was found, and three cases showed apparently normal x-ray finding of the chest.The bronchial tumors of each type showed no characteristic appearances. However, as to the localization, the tumors of the third type were most frequently located at the carina, the orifice of the right upper lobe bronchus and the median wall of the right main bronchus and the intermedial bronchus.Therapeutecally, it should be most significant to distinguish each type of the bronchial tumors. In the early stage, the bronchial tumors of the first type not only were resectable, but also mostly diappeared or could be replaced with cicatricial tissue by the suitable irradiation therapy, while in the majority of the cases with the tumors of the othere types, their prognoses were less good than those in the former.In our series, 11 cases (52%) of the first type, 3 cases (5.1%) of the second and 4 cases (20%) of the third were treated by lung resection, but only one case of the first type survived for more than five years.