Radiological and Histopathological Features of Lung Carcinoma in a Tertiary Level Hospital: A Cross-sectional Study

Abstract

Introduction: Lung cancer is a leading cause of mortality globally and in Nepal. Computed tomography (CT) is the preferred screening modality for detection of primary lesions; histopathological examination remains gold standard for definitive morphological diagnosis and subclassification. Methods: This one-year hospital-based descriptive cross-sectional study analyzed patients with clinically and radiologically suspected lung carcinoma who underwent contrast-enhanced CT of the chest followed by CT-guided percutaneous transthoracic core needle biopsy and in whom histopathological examination showed unequivocal features of malignancy. CT chest and CT-guided biopsy were performed by the same interventional radiologist. The final histopathological diagnosis was reviewed by three pathologists. Demographic findings, smoking history, CT and histopathological findings were analyzed using frequencies and percentages, and age using mean and range. Results: Sixty patients were included in the study. There were 23 (38.33%) males and 37 (61.67%) females. Squamous cell carcinoma (SCC) was seen in 28 (46.67%) cases and adenocarcinoma in 20 (33.33%) cases. Squamous cell carcinoma was central in 17 (60.71%) cases and adenocarcinoma was peripheral in 15 (75%) cases. Radiological findings included mediastinal lymphadenopathy 49 (81.67%) and adjacent tissue invasion 29 (48.33%). Thirty nine (65%) cases had a positive smoking history. Conclusions: Squamous cell carcinoma was the most frequent and commonly central, whereas adenocarcinoma was commonly peripheral. Mediastinal lymphadenopathy was the predominant CT finding, followed by adjacent tissue invasion and hilar enlargement. These findings may aid lesion assessment and biopsy planning, but histopathology remains essential for definitive classification.