The association of adenocarcinoma and hemosputum in pulmonary malignancies

Background: Hemosputum was considered one of the popular symptoms of patients with centrally located carcinoma of the lung, especially squamous cell or small cell type. Recent studies reported a relative increase in adenocarcinoma compared with squamous cell carcinoma, especially in developed countries.

Objectives: The main purpose of this study was to determine the trend of histological type associated with the occurrence of hemosputum in patients with pulmonary malignancy.

Methods: Retrospectively, the data from 1,050 patients with pulmonary malignancy who underwent bronchoendoscopic examination at our institution between May 1993 and May 2000 were analyzed.

Results: One hundred and forty-nine out of 1,050 patients had hemosputum. There were 66 patients with adenocarcinoma, 55 with squamous cell carcinoma, 15 with small cell carcinoma, 5 with large cell carcinoma, 3 with other cell type carcinoma and 5 with metastatic carcinoma. On bronchoendoscopic examination, abnormal findings in the segmental or more proximal bronchi were found in 82 patients, including 36 with squamous cell carcinoma, 31 with adenocarcinoma, 12 with small cell carcinoma, 2 with large cell carcinoma and 1 with metastatic carcinoma. On the other hand, 67 patients were diagnosed with pulmonary malignancy in the subsegmental or more distal area, including 35 with adenocarcinoma, 19 with squamous cell carcinoma, 3 with small cell carcinoma, 3 with large cell carcinoma, 3 with other cell type carcinoma and 4 with metastatic carcinoma.

Conclusions: The most frequent histological type of malignancy with hemosputum was adenocarcinoma. The number of abnormalities in the peripheral region with hemosputum showed a progressive increase. The number of adenocarcinoma with hemosputum was increased in both central and peripheral regions.