Document 0484
 DOCN  M9440484
 TI    Fiberoptic bronchoscopy in the evaluation of carcinoma metastatic to the
       lung.
 DT    9404
 AU    Argyros GJ; Torrington KG; Department of Medicine, Walter Reed Army
       Medical Center,; Washington, DC 20307.
 SO    Chest. 1994 Feb;105(2):454-7. Unique Identifier : AIDSLINE MED/94139403
 AB    To determine the clinical presentation of patients with malignancies
       metastatic to the lung, the diagnostic utility of fiberoptic
       bronchoscopy (FB), and the primary site of malignancies metastasizing
       endobronchially, we retrospectively reviewed 1,853 FB records (1987 to
       1991) and selected 111 cases for review. Cases were divided on the basis
       of FB findings into abnormal (44 patients) and normal (67 patients).
       Pulmonary symptoms (cough, hemoptysis, and chest pain) prompted referral
       significantly more often in the abnormal FB group (34/44) than in the
       normal FB group (24/67). The finding of atelectasis on chest radiograph
       occurred more frequently in patients with endobronchial abnormalities.
       The spectrum of extrapulmonary malignancies that metastasize
       endobronchially has changed during the AIDS epidemic. Our study shows
       the most frequent causes of endobronchial mass lesions were Kaposi's
       sarcoma and the lymphoma group (Hodgkin's disease, nonHodgkin's
       lymphoma, chronic lymphocytic leukemia) and the most common malignancies
       causing submucosal metastases were breast and the lymphoma group. In
       summary, the highest yield from FB can be expected in patients
       experiencing symptoms of cough or hemoptysis and/or having radiographic
       evidence of atelectasis. We propose a new mnemonic KLAS (Kaposi's
       sarcoma, Lymphoma, Adenocarcinoma, Sarcoma) to describe the malignancies
       most likely to metastasize endobronchially in the 1990s.
 DE    Atelectasis/DIAGNOSIS  Biopsy  Breast Neoplasms/PATHOLOGY  *Bronchoscopy
       Carcinoma/*DIAGNOSIS/PATHOLOGY/*SECONDARY  Chest Pain/DIAGNOSIS  Cohort
       Studies  Cough/DIAGNOSIS  Evaluation Studies  Female  Fiber Optics
       Hemoptysis/DIAGNOSIS  Human  Lung
       Neoplasms/*DIAGNOSIS/PATHOLOGY/*SECONDARY  Lymphoma/PATHOLOGY  Male
       Retrospective Studies  Sarcoma, Kaposi's/PATHOLOGY  Support, U.S. Gov't,
       Non-P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).