Comparison of tumor density by CT scan based on histologic type in lung cancer patients.

AIM: To investigate the differences of tumor density of lung cancer by CT scan based on histopathologic type of cancer cell. METHODS: Subjects were lung cancer patients at Dr. Kariadi hospital Semarang between January 2002 and December 2003. Diagnosis was made based on clinical symptoms, histologic examination and lateral chest radiograph, and thorax CT scan. Density of tumor was measured within area which had most enhancements before and after contrast administration. Then, it was followed by transthoraxic fine needle aspiration (TNFNAB) and histopathologic examination. Study design was a cross sectional study. Inclusion criteria were primary lung cancer and exclusion criteria were non lung cancer, metastatic cancer, histopathologic non interpreted. Estimated number of samples was 41 patients. Density value before and after contrast were analyzed using Wilcoxon signed rank test. Difference of tumor density for each type of cancer cell was analyzed using chi-square test with significant level at p < 0.05 and confidence interval of 95%. RESULTS: Forty-one patients with lung cancer were enrolled in this study. There were 30 males (73.2%) and 11 females (26.8%). Histopathologic types of cell cancer were epidermoid in 17 patients (14.5%), adenocarcinoma 8 patients (19.5%), large cell 7 patients ( 17.1%), small cell 7 patients ( 17.1%) and undifferentiated cell 2 patients ( 4.5%). Mean of increasing HU before and after contrast in epidermoid carcinoma was 26.8 (10.4) HU, adenocarcinoma 17.2 (7.1) HU, large cell 8.7 (4.5) HU, small cell 9.9(4.1) HU and undifferentiated cell 23.5 (1.5) HU with overall increase of all cancer cell types was 17.3(9.2) HU, p < 0.001. Histopathologic type of non small cell lung carcinoma (NSCLC) with density < 60 HU was found in 30 patients (73.2%) and small cell lung carcinoma with density > 60 HU was found in 5 patient (12.2%), p=0.01. CONCLUSION: There was evident increase of density in all histopathologic type of cell cancer, p < 0.0001, with mean of density after contrast administration was 17.2 (7.1). There was significant difference between NSCLC and SCLC group and tumor density > 60 HU and < 60 HU, p=0.01.

[Small round cell tumours with unknown origin in pathology specimens of iman reza hospital from 1362-1382]

The term" small round cell tumour"describes a group of highly aggressive tumours composed of relatively small and monotonous undifferentiated cells with high nuclear to cytoplasmic ratio. This group includes: Ewing sarcoma [EWS], Peripheral neuroepithelioma [PN], Primitive neuroectodermal tumour [PNET], Neuroblastoma, Rhabdomyosarcoma [RMS], Desmoplastic small round cell tumour [DSRCT], Lymphoma, Leukemia, Small cell osteosarcoma Small cell carcinoma, Olfactory neuroblastoma, Merkel cell carcinoma, Small cell melanoma, and Mesenchymal chondrosarcoma. Their clinical presentation often overlap, thus making a definitive diagnosis problematic in some cases. Yet, a clear undrestanding of their clinicopathologic features usually allows for a confident diagnosis, especially if immunohistochemistry is used. This is an immunohistochemistry study of small round cell tumours with unknown origin that were diagnosed in pathology service of Imam Reza Hospital from 1362-1382. In this period, we found 24 cases which were reported SRCT without definitive diagnosis the immunohistochemistry kits are from DAKO Company and applied as directed by manufacturers. The SRCT is most frequent in the first decade of life [45%], 13 cases were male and 11 cases were female. IHC influence on diagnosis in 11 cases [46%] confirm the first ordered diagnosis and diagnosis made in another 9 [33%] of SRCTs,and in 2cases[8%]the first diagnosis was changed. Overally in review, 35 cases from 48 SRCTs with unknown origin [%75] were diagnosed by routine stainings by light microscopy without immunohistochemistry