HEMOPTYSIS - COMPARATIVE-STUDY OF THE ROLE OF CT AND FIBEROPTIC BRONCHOSCOPY

PURPOSE: A prospective study was performed to compare results of compu ted tomography (CT) and fiberoptic bronchoscopy in diagnosis of cancer in patients with hemoptysis. MATERIALS AND METHODS: Ninety-one patien ts (64 men, 27 women) with hemoptysis underwent thin-section CT and fi beroptic bronchoscopy. RESULTS: CT scans demonstrated all 27 tumors se en at bronchoscopy and an additional seven, five of which were beyond bronchoscopic range. In patients with normal chest radiographs, bronch ial carcinoma was detected in 5% at both bronchoscopy and CT. In patie nts with abnormal findings on radiographs, bronchoscopy allowed both l ocation and histologic diagnosis in 78% of carcinomas but was unreliab le in locating perpheral tumors demonstrated at CT. CT was insensitive in demonstrating early mucosal abnormalities, bronchitis, squamous me taplasia, and a benign papilloma, all detected at bronchoscopy. CONCLU SION: The initial examination should be bronchoscopy when there is hig h clinical suspicion of carcinoma and relevant radiographic abnormalit y, and CT when strong clinical suspicion of carcinoma is not substanti ated at bronchoscopy in patients with normal findings on chest radiogr aphs.