The authors observed clinically, with analysis, 671 patients with various pulmonary diseases who had taken flexible bronchofiberscopy in the Department of Internal Medicine. Presbyterian Medical Center, Jeonju, from March 1975 to July 1980. The following results were obtained:
1) Each bronchoscopic diagnosis in the 671 cases was classified as follows: lung cancer 360 cases (53.6%, primary lung cancer 345 cases, metastatic lung cancer 15 cases, inflammatory lung disease 263 cases (39.2%), extrabronchial lesion 18 cases (2.1%), others 20 cases (3.0%)and undiagnosed 10 cases (1,5%).
2) Bronchofiberscopic diagnostic rate of primary lung cancer was 93.9% (324/345), and the histological confirmed rate was 66.3%.
3) The classification of the primary lung cancer confirmed histologically was epidermoid carcinoma 151 cases (70.2%), adenocarcinoma 23 cases (10.7%), undifferentiated carcinoma 40 cases (18.6%) and bronchiolo-alveolar cell carcinoma 1
case (0.5%).
4) Bronchofiberscopic findings of various types of lung cancer as follow: epidermoid carcinoma showed mainly tumor mass and obstruction; adenocarcinoma showed obstruction, compression and normal finding; undifferentiated carcinoma revealed tumor mass, obstruction, compression, and infiltration: and bronchiolo-aveolar cell carcinoma revealed multinodular tumor mass.
5) The 21 cases of primary lung cancer in which bronchoscopic finding showed no abnormal evidenence were diagnosed by the following method: 3 cases by sputum cytology, 4 cases by node biopsy, 6 cases by pleural biopsy and pleural fluid cytology and 8 cases suspected by bronchography.
6) We could net differentiate the various inflammatory lung diseases by bronchofibersopy only. But in the bronchofiberscopic examination of various inflammatory lung diseases, we observed the nature of the wall and lumen of bronchus, resulting as follows: in bronchitis and pneumonia, the bronchial wall appeared as edema :and hyperemia, and the bronchial lumen showed normal finding; in pulmonary tuberculosis and bronchiectasis, the bronchial wall showed edema, hyperemia, exudate, and bleeding and bronchial lumen revealed stenosis and deformity, especially luminal widening as a characteristic finding in bronchiectasis. Lung abscess had purulent disclarge on the bronchial wall and showed normal lumen of the bronchus.
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