Delayed Clearance of Tantalum by Radiologically Occult Cancer

Abstract

The best current treatment of bronchogenic carcinoma is prompt surgical excision of early lesions before mediastinal and extrathoracic spread occurs. Bronchoscopy, in a patient with a positive cytology and a negative chest radiograph, is a long, time-consuming procedure. Tantalum bronchography done prior to the bronchoscopy will significantly reduce the time necessary for bronchoscopy. Tantalum is cleared solely by mucociliary action. Early bronchogenic carcinoma, when sufficiently large enough, will destroy the ciliated epithelium, thus impairing mucociliary clearance and altering mucus secretion. Tantalum bronchography has localized these early x-ray negative lesions, both by minimal mucosal irregularity and by delayed clearance. In the past three years we have localized the radiologically occult malignancy in four out of five patients.