TY - CHAP M1 - Book, Section TI - Management of Superficial Central Airway Lung Cancers A1 - Savani, Ravi A1 - Andoh-Duku, Augustine A1 - Demmy, Todd L. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - Squamous cell lung cancer represents between 20% and 30% of all primary lung malignancy.1 It is believed that most squamous cell cancers begin in the central airway and will evolve in a stepwise, predictable way. These cancers are preceded by premalignant lesions that include squamous metaplasia, squamous dysplasia, and carcinoma in situ (CIS). Evidence of premalignant change is detected inconsistently in the induced sputum of high-risk individuals. If the carcinogenesis progresses, eventually central airway tumors will shed malignant cells that can be detected in sputum cytology preparations. Early superficial central airway cancers do not shed malignant cells in a reliable way, and the large-scale lung cancer screening trials of the 1970s and 1980s failed to demonstrate a mortality benefit from lung cancer screening with sputum cytology. Nonetheless, a small percentage of patients were identified with positive sputum cytology despite a normal chest x-ray in these trials. Cancers in this category were termed radiographically occult lung cancers. Although radiographically occult, many of these cancers were found to be early invasive carcinomas, arising from the segmental bronchi with metastases to adjacent lymph nodes. Diagnoses of these lung cancers were confirmed typically with white-light bronchoscopy (WLB). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170411419 ER -