Revista chilena de cirugía
versión On-line ISSN 0718-4026
LUCENA O, JORGE R; CORONEL, PAÚL y ORELLANA, YSABELEN. Benign pulmonary nodules excised for suspicion of malignancy. Rev Chil Cir [online]. 2009, vol.61, n.1, pp. 27-32. ISSN 0718-4026. doi: 10.4067/S0718-40262009000100005.
Background: The management of incidental pulmonary nodules discovered during imaging studies may range from clinical observation, percutaneous needle aspiration to open surgery. The predictive valué for malignancy of imaging studies is low. Aim: To report our experience with nodular pulmonary lesions suggestive of lung cáncer and subsequently proven benign on histological examination. Material and Methods: A retrospective analysis of the medical records of 140 patients aged 59 ± 15 years (107 males) in whom a focal pulmonary lesión was excised at our institution from October 1984 to august 2007. Computed tomography and pathology reports were reviewed for all patients. Fluorine-18-flurodeoxyglucose positrón emission tomography studies were performed on 43 patients. Lesions were excised by thoracotomy and video-assisted thoracoscopy, and sternotomy. All lesions were diagnosed as benign on pathology. Results: One patient died in the postoperative period. Pathologic diagnoses of the surgical pieces were granulomatous inflammation in 65%, hamartomas in 12%, pneumonia or pneumonitis in 10%, fibrosis in 4% and other in 9%. Fluorine-18fluorodeoxyglucose positrón emission tomography imaging suggested malignancy in 22 of 43 patients. Conclusions: Despite thorough clinical assessment, advanced imaging technology, and needle biopsy, many patients continué to undergo surgery for benign diseases. Aggressive attempts to diagnose and treat early stage lung cáncer must be tempered with understanding.
Palabras clave : Lung cáncer; pulmonary lesions; positrón emission tomography.