| Summary: | Background: Picking up of the clinical significance of pulmonary opacities in patients with extra- pulmonary malignancy is an urgent need for evaluating it. As, most physicians expect them to be pulmonary metastases which are deemed incurable and are assigned to palliative treatment. This assumption directly affects the treatment and prognosis of patients.
Aim of the study: Is to investigate the clinical significance of pulmonary shadows in these patients, and to distinguish malignant from benign opacities and attention should be paid to the pathological diagnosis of those opacities in order to avoid over or under treatment.
Patients and Methods: Prospective, observational study conducted in Chest and Oncology departments, Zagazig University Hospitals, in the period from October 2014 to September 2016. The study was carried out on 100 patients with pathologically and clinically proved extrapulmonary malignant neoplasm and different radiological pulmonary lesions undiagnosed. CT chest and bronchoscopy were done for all patients and Samples were subjected to cytology, histopathology, AFB staining, fungal smear and culture/sensitivity, depending upon the findings.
Results: The results of pathological types of lung lesions revealed that metastatic lesions (69%) were the commonest followed by benign lesions (18%) and primary lung cancer (13%). Patients with current smoking history and advanced stage of primary tumor have significant liability to have lung malignancy. Also, patients who showed multiple pulmonary nodules, ground glass opacities and mass in their CT finding have higher liability to have lung malignancy rather than other findings with high statistical significance (P value <0.001).
Conclusion: Patients presented with advanced stages of primary extrapulmonary malignancy, current or former smokers, with multiple pulmonary nodules or mass in computed tomography of the chest, were more liable for being malignant and needs diagnostic biopsies.
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