Chest
Bronchoscopy to Evaluate Hemoptysis in Older Men with Nonsuspicious Chest Roentgenograms
Section snippets
METHODS
The reports of all bronchoscopic examinations done at the Minneapolis Veterans Administration Medical Center hospital and clinic from Jan 1, 1979, through Dec 31, 1987, were reviewed. Charts were obtained and reviewed on all potentially eligible patients. Medical histories and final diagnoses were obtained from the attending physicians’ notes, and chest roentgenograms were classified according to the radiologists report. Eligible patients included men more than 40 years old who underwent
RESULTS
One hundred six men more than 40 years old (mean age, 61 years) underwent fiberoptic bronchoscopy for hemoptysis and a nonsuspicious chest roentgenogram during the study period. Most patients had no more than 5 ml per day of hemoptysis, and many of these reported only “flecks” or “streaks.” Mean smoking history was 54 pack-years, and 89 percent of the patients had a smoking history of at least 20 pack-years. There were 58 current smokers, 41 ex-smokers, and seven patients who had never smoked.
DISCUSSION
Six of 106 men more than 40 years old who underwent fiberoptic bronchoscopy for hemoptysis and a nonsuspicious chest roentgenogram were discovered to have cancer, a rate of 5.7 percent. This represents one cancer detected for every 18 bronchoscopic examinations performed. This finding does not support the conclusion of several other studies5, 6 regarding the benign nature of this presentation, at least in older men with substantial smoking histories. Rather, our results are similar to the 8.5
ACKNOWLEDGMENTS
The authors thank Katherine M. Osten and Sheila J. Merrier.
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Cited by (43)
The clinical implications of bronchoscopy in hemoptysis patients with no explainable lesions in computed tomography
2012, Respiratory MedicineCitation Excerpt :In this study, the initial bronchoscopy gave a diagnosis in 16.2% of patients, and one (0.4%) of them was diagnosed with lung cancer by bronchial washing cytology during the initial episode of hemoptysis. Previous studies found a 0–16% cancer detection rate for bronchoscopy in patients with hemoptysis and normal chest radiograph.9–11 Kaminski et al. 12 reported a cancer detection rate of up to 21% and 83% diagnostic value for nonspecific bronchitis and tuberculosis for a single bronchoscopy in patients with hemoptysis and normal chest radiograph.
Early diagnosis of cancer by imaging: The primary care perspective
2012, RadiographyCitation Excerpt :Secondary care studies of patients with normal CXRs and lung cancer have examined patients complaining of either haemoptysis or dyspnoea. Cancer is diagnosed in 6–21% of patients who have haemoptysis and a normal X-ray, who are referred for further investigation.7–11 For dyspnoea and normal X-rays, the yield of cancers is under 1%.12–14
Bronchoscopy and surgical staging procedures and their correlation with imaging
2003, European Journal of RadiologyHemoptysis: A retrospective analysis of 108 cases
2002, Respiratory MedicineFlexible bronchoscopy in the elderly
2001, Clinics in Chest Medicine
Presented at the National Meeting, Society of General Internal Medicine, Washington, DC, April 28, 1988.
Manuscript received July 20; revision accepted September 23.