How frequently do endobronchial secondaries occur in an unselected series?

Isolated endobronchial secondaries are reported usually as single cases or in series from either specialist surgical or cancer units. The latter two are selected populations and are not a good guide to the true frequency of occurrence of such isolated endobronchial secondaries. The incidence of such endobronchial secondaries in a 15 yr prospective series is reported. Results of all fibre-optic bronchoscopies carried out in the Blackburn, Hyndburn and Ribble Valley districts from 1981 to 1995 together with histology were recorded prospectively throughout the period. These had been audited yearly throughout, the data were collated, and the individual records of cases of endobronchial secondaries examined. A total of 3353 bronchoscopies were carried out in the years 1981–1995 inclusive. Of these, 1391 had visible endobronchial abnormalities, from which 1059 had positive endobronchial histology. Sixteen of the 1059 (1·5%) were with endobronchial secondaries. Over the same period eight bronchial carcinoids (none biopsied, but later surgically resected) were encountered. Isolated endobronchial secondaries made up a higher proportion of endobronchial histology than expected at 1·5% and were twice as frequently found as bronchial carcinoids. The possibility of endobronchial secondaries should always be considered in those with a history of previous carcinomas at other sites.