The Changing Radiographic Presentation of Bronchogenic Carcinoma With Reference to Cell Types

To analyze chest radiographic patterns of lung cancer at presentation by cell type. This current series is compared with historic published data. Retrospective, using a tumor registry. Large, rural multispecialty clinic. Three hundred forty-five patients with newly diagnosed lung cancers presenting between October 1990 and August 1992. Radiographs were interpreted by two radiologists blinded to cell type. Our results were compared statistically to published data from Mayo Clinic patients in the 1950s and 1960s. Decreased presentation as a peripheral tumor in current series (49%) compared with historic control at Mayo (72%); (2) squamous cell: increased presentation as peripheral tumor in current series (43%) compared with historic control (31%); and (3) no statistically significant difference between adenocarcinoma (49%) and squamous (43%) for a presentation as a peripheral mass, or between adenocarcinoma (46%) and squamous (52%) for central origin in the current series of cases. As adenocarcinoma has increased in relative frequency among lung cancers, the percent of cases with peripheral primary tumors is decreased while central tumors have increased. Squamous carcinoma has had a relative increase in peripheral mass presentation. There is now no significant difference between these two cell types in percent presenting as a peripheral mass or central tumor on chest radiograph.