The Diagnosis of Primary Carcinoma of the Lung by Aspiration

Abstract

The diagnosis of primary carcinoma of the lung is difficult. The clinical features and x-ray findings are frequently inconclusive. A bronchoscopic examination furnishes a method by which biopsy material may be obtained and a definite diagnosis established in a large percentage of cases. However, it is only of value when the carcinoma appears in the field of vision. Only when the process has extended down within the lumen of a bronchus to one of the main divisions, or when it has invaded directly the walls of one of the main bronchi, is the bronchoscope of advantage. Early lesions located in either of the upper lobes or in the parenchyma near the periphery of the lung, therefore, offer the greatest difficulty with the present diagnostic methods.

An effective procedure has recently been described by Martin and Ellis for the biopsy of tumors which lie beneath the body surfaces where surgical methods are contraindicated. Their method, biopsy by needle puncture and aspiration, is particularly adaptable to primary carcinomas of the lung. The technic is relatively easy, and with some experience an immediate histologic diagnosis may be made without hospitalization.

Martin and Ellis demonstrated sixty-five aspiration cases, and of these, two are primary carcinomas of the lungs. The technic of needle puncture and aspiration used in these instances was described fully by them, and reference should be made to their original paper. Brief summaries of their two cases are given below, followed by one by the author, in order to furnish some basis for judgment of the advantages of this diagnostic procedure.