CLINICAL IMPACT OF ADRENAL EXPANSIVE LESIONS IN BRONCHIAL-CARCINOMA

Purpose: To estimate the prevalence of adrenal expansive lesions in pa tients with bronchial carcinoma, and assess the relationships among ad renal masses, TNM classification, and histology of the bronchial carci noma, and to reveal other signs of inoperability in these patients. Ma terial and Methods: CT findings of the thorax and upper abdomen in 96 patients with bronchial carcinoma were reviewed. Brain- and upper abdo minal metastases, together with TNM classification and histology of th e bronchial carcinoma, was recorded. CT was performed with IO-mm slice thickness from the thorax aperture to the renal hilum under i.v. cont rast medium injection. Results: Eight adrenal expansive lesions (1.5-1 0 cm, mean 4.6 cm) were revealed in 6 of the 96 patients (6.3%). Two o f these patients, classified as NO, had metastases in other organs; on e had brain metastases and the other liver metastases. The bronchial c arcinomas in the remaining 4 patients were classified as N3. Three of the patients had adenocarcinoma, one each of small-cell-, large-cell-, and unclassified bronchial carcinoma. Squamous cell carcinoma was mos t common in the total patient population, but no patient with adrenal masses showed this histologic type. Conclusion: The finding of adrenal expansive lesions in bronchial carcinoma has little clinical impact, because these patients usually show other signs of inoperability. Henc e, the value of upper abdominal CT as a routine examination is questio nable.