Bronchographic Signs Useful in the Diagnosis of Lung Cancer

¹ Resident Physician in Radiology, Senior Clinical Trainee, Division of Chronic Diseases, United States Public Health Service
² Associate Professor of Radiology

Bronchography is a useful tool in the diagnosis of lung cancer. A complete bronchographic study which should include chest fluoroscopy will uncover more than 89 per cent of all cases of pulmonary malignancy. It provides a greater diagnostic yield than any other standard screening method including bronchoscopy, scalene node biopsy and cytologic examination of sputa, aspirates and pleural fluid. It enables identification and localization of upper lobe bronchus tumors which are inaccessible to the bronchoscope.

Shifts of the mediastinum, diaphragmatic abnormalities and pleural effusions which are noted at fluoroscopy help to identify and localize lung cancers. Fluoroscopic monitoring of the instillation of contrast medium is necessary to ensure complete filling and enables spot film recording of findings.

Bronchial alterations which are found in pulmonary malignancy include abrupt bronchial obstruction, localized bronchial displacement, concentric bronchial narrowing, "thumb-print" impression and abrupt bronchial narrowing without termination.