A STUDY ON ETIOLOGY AND DIAGNOSTIC MODALITIES OF CASES WITH\nSOLITARY PULMONARY OPACITY IN CHEST ROENTGENOGRAM

Abstract

INTRODUCTION: In various mass screening programmes, 0.09-2% of chest radiographs have revealed solitary\npulmonary nodules. This continues to pose a diagnostic challenge and therefore the signi\uf001cance of its proper evaluation\nto differentiate between benign and malignant causes. The study was carrie MATERIALS AND METHODS: d out in the Department of\nRespiratory Medicine of IPGMER, Kolkata for a period of one & half year (November 16 to May 2018). Help was also sought from various\ndepartments of IPGMER, specially the Departments of Pathology, Microbiology, Cardiothoracic surgery and Radiotherapy. Fine needle\naspiration cytology of lung opacity under guidance of computerized tomography was performed in Radiology Section of the Bangur Institute of\nNeurology, Calcutta, Department of Radiotherapy, IPGMER and The CT-Scan Centre of Medical College, Kolkata. A total of 73 cases showing\nsolitary pulmonary opacity and obeying the selected criteria were selected for the study of which 56 cases are being evaluated in this study as 17\ncases were either lost to follow-up or data was incomplete and hence were excluded. The study showed RESULT AND ANALYSIS:\nbronchogenic carcinoma as by far the most common cause of solitary pulmonary opacity occurring in 45% of the total cases. Majority of the\ncases of bronchogenic carcinoma were of squamous cell variety (48%) followed by adenocarcinoma (36%). Small cell carcinoma (4%) and\nanaplastic carcinoma (12%) were less common. Among the benign causes, tuberculoma was the commonest cause seen in 21.4% cases followed\nby metastasis from other sites (9%). Solitary pulmonary opacity due to bronchogenic carcinoma was seen more in elderly subjects (Mean age of\nthe subjects with bronchogenic carcinoma was 58.9 years while for tuberculoma & hydatid cyst cases the mean ages were 43.3 years and 41 years\nrespectively). The present study showed that meticulous clinical evaluation, careful study of c CONCLUSION: hest roentgenogram coupled\nwith judicious use of investigations like \uf001ber optic bronchoscope andCT guided aspiration cytology make it possible to diagnose the etiology of\nsolitary pulmonary opacitieswithoutresortingtomajorsurgicalprocedures.Althoughthis doesnotunderestimatethe needforthoracotomy\nwhichisthe\uf001nalanswertotheproblemofundiagnosedsolitarypulmonary opacity, The present study can be regarded as yet another illustration of\nthe current trend of evaluation of pulmonary opacities by increasing use of non-invasive investigation procedures bases on recent\ntechnologicaladvances.