Diagnosis of liver metastases in bronchogenic carcinoma:A comparative study of liver scans, function tests, and peritoneoscopy with liver biopsy in 111 patients

Evaluation of hepatic metastases was performed in a series of 111 patients with untreated unresectable bronchogenic carcinoma, comparing liver chemistries with liver scanning and peritoneoscopy with liver biopsy under direct vision. The latter procedure proved metastases in 10.2% of 98 patients biopsied, including 8 of 19 patients with small cell carcinoma, 1 of 41 with epidermoid carcinoma, 1 of 24 with adenocarcinoma, and 0 of 14 with large-cell anaplastic carcinoma. Correlation of the histopathologic findings with liver scan and liver chemistries is discussed. The findings demonstrate that peritoneoscopy and liver biopsy under direct vision are indicated in order to obtain optimal staging in many cases of small cell carcinoma, and for the other cell types in those patients whose liver scans and/or liver enzymes are suggestive of malignant hepatic involvement.