Original Article Efficacy of Bronchial Wash and Brush Cytology and its correlation with (original) (raw)
Related papers
Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours
JPMA. The Journal of the Pakistan Medical Association, 2004
To evaluate bronchial wash cytology with histology in our set up. Seventy three specimens were obtained by flexible fiberoptic bronchoscope at pulmonology department of Military Hospital Rawalpindi. All the preserved samples were processed under standard conditions. The slides were stained with Papanicolaou and Haematoxylin and Eosin stains. A total of 73 patients were studied. The age range was 21 to 80 years. Male to female ratio was 8:1. Complete cytological and biopsy consensus was found in 55 (77.4%) cases. Cytology revealed 24 cases as malignant and nine as atypical/suspicious. Benign and inadequate were 29 and 2 respectively. Histopathology of these cases confirmed 24 (32.9%) as malignant and 29 (39.8%) as benign. True positive alongwith suspicious/atypical were 33 and true negative cases were 29. False positive was one case only whereas false negative cases were eight. The bronchial wash cytology showed sensitivity (80.5%), specificity (96.6%) and accuracy (87.3%). Positive ...
Annals of Pathology and Laboratory Medicine, 2021
Introduction: Cytological evaluation is an important, usually initial diagnostic modality in patients with suspected malignant lung masses. Bronchoscopic washing, bronchoalveolar lavage, bronchial brushing and fine needle aspirations may complement tissue biopsies in the diagnosis of lung cancer. This study was undertaken to compare the efficacy of bronchial wash cytology and to correlate it with histopathology in diagnosis of suspected cases of lung cancer at a tertiary care hospital. Material and methods: Bronchial washings and bronchial biopsy were collected from total 60 clinically suspected cases of carcinoma lung. Bronchial washing smears were stained with MGG and H&E stain and were categorized as unequivocally positive / unequivocally negative for malignancy and atypical (equivocal for diagnosis). Biopsy sections were examined for histopathological diagnosis. Results: Cytomorphologically, 30 cases were reported as positive for malignancy, 28 cases were negative for malignancy...
Bronchoscopic Brush Cytology in the Diagnosis of Lung Lesions
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Respiratory cytology has assumed a primary diagnostic place in the makeup for patients with pulmonary disease. Diagnosis of cellular specimens from the respiratory tract is established throughout the world as a vital diagnostic procedure in evaluation of any patient with a suspected lung lesion in which morphological confirmation is indicated. At present, most of the major medical institution throughout the world utilise some combination of various cytological specimens in the diagnostic workup of patient with suspected lung cancer. MATERIALS AND METHODS Samples were collected from patients with definite lung lesions and subjected to fiberoptic bronchoscopy referred from various departments of V.S.S. Medical College Hospital. Specimens of brush cytology and biopsy from the site of lesion of histopathological study were included. RESULTS Majority of them were males (88%). Majority of cases were in the age group of 51 to 60 years and were of inflammatory origin. Inflammatory cases age range was from 21-70 years, whereas for malignant cases, the age range was from 31-70 years. Both inflammatory and malignant lesions were more common in older age groups (5 th to 6 th decade). Radiologically, the zonal distribution of lesions revealed maximum number of cases in the mid zone 16 cases (37.20%), which coincided with the central lesions of bronchoscopy. CONCLUSION Bronchoscopic brush cytology is a simple, safe and inexpensive procedure for diagnosis of lung lesions.
Bronchial Brushing Cytology in Evaluating Lung Cancer: Efficacy and Pitfalls
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.11\_Nov2019/IJHSR\_Abstract.01.html, 2019
Introduction: Lung cancer is one of the most common cause of mortality among cancer patients. A comprehensive clinicopathological approach is needed for labelling a correct diagnosis. Cytological diagnosis following fine needle aspiration (FNA) plays a pivotal role in diagnosis of lung cancer; especially in advanced stages and cases where biopsy may not be feasible. Besides, there is diagnostic role of exfoliative cytology by bronchial brushings which is a non-invasive procedure.). A total of 302 reported cases of bronchial brushing cytology were included. Categorisation was done based upon cytological diagnosis; however, immunocytochemistry was not done due to financial constraint. Histological correlation along with immunohistochemistry was done wherever available. Results: Out of a total of 302 bronchial brushing cytology specimens, 208 were males and rest 94 females. The age of the patients ranged from 17-84 years with a mean age of 50.2 years. Histological findings were available in 152 cases. A total of 68 cases were reported as malignant on cytology; of which 36 cases had positive histological correlation and in rest 11 cases biopsy was inadequate. Eighty-four cases with negative cytological findings had similar histology (p value <0.05); however, 21 cases which were reported as negative on cytology had evidence of malignancy on histology. An attempt to classify the tumors into small cell lung carcinoma (SCLC) and non-small lung carcinoma (NSCLC) was done along with subclassification into adenocarcinoma and squamous cell carcinoma wherever possible. Diagnostic difficulty leading to misdiagnosis was noted in 5 cases. Few cases of pulmonary tuberculosis and occasional rare malignancies were also diagnosed on bronchial brushings while evaluating the patients clinically suspected for lung carcinoma. Conclusion: Bronchial brushing cytology can play an excellent role in initial evaluation of lung cancer by giving an early diagnosis. Subclassification of lung tumors into SCLC or NSCLC can rarely be difficult on cytomorphology alone. In cases where biopsy is not feasible or histological findings are inadequate, bronchial brushing cytology is a reliable alternative for an early diagnosis and patient management.
Usefulness of Bronchial washings in diagnosing lung malignancy
Objective: The present study was done to evaluate the yield of bronchial wash in cases of lung cancer. Methods: This is a 3 year retrospective study which included 163 cases of lung cancer in whom bronchial wash cytology had been done. Results: The age range was from 34 to 88 years and Male: Female ratio was 5.5:1. The sensitivity of bronchial wash was found to be 24.5% and the false negative index was 32.5%. The sensitivity of endobronchial biopsy was 93.4%. Tumor typing into small cell carcinoma and non-small cell carcinoma could be done on cytology in 85% of cases positive on bronchial wash. Squamous cell carcinoma was the most common type. Interestingly one case was diagnosed as Adenoid cystic carcinoma which was later confirmed on biopsy. Conclusion: There is still disagreement as to the value and reliability of bronchial wash cytology in diagnosing lung cancer. Bonchial wash cytology has low sensitivity for detecting lung cancer; however, it may be a useful diagnostic test in patients in whom endobronchial biopsy cannot be done.
Turkish Journal of Pathology, 2012
Objective: The present study is based on the cytologic evaluation of bronchial brushings for the diagnosis of non neoplastic and neoplastic bronchopulmonary lesions and relation of the cytologic findings with clinical diagnosis and histopathologic examination wherever possible. Material and Method: 35 symptomatic patients were selected on whom bronchoscopy was done. Bronchial brushing was performed using straight brushes and bronchial washing specimens were collected after brushing samples. Smears were stained by PaP, H&E, and Giemsa in all the cases while PaS and ziehl neelsen stainings were done in selected cases. Endobronchial biopsy was performed using a flexible long biopsy forceps. Results: The age of the patients varied from 18 to 88 years, and the male:female ratio was 3.3:1. Carcinoma was diagnosed in 21 (60%) out of total 35 cases on bronchial biopsy and the remaining 14 cases (40%) showed inflammatory, tuberculous or no significant pathology. Bronchial washing showed 10 true positive, 10 true negative, 4 false positive and 11 false negative cases whereas bronchial brushing showed 17 true positive, 12 true negative, 2 false positive and 4 false negative cases as confirmed on biopsy. Bronchial brushing showed good sensitivity (80.9%) and specificity (85.7%) compared to bronchial washing which had sensitivity of 47.6% and specificity of 71.4%. Conclusion: These findings attempted to confirm the concept that pulmonary cytology has improved to the point that its sensitivity is high enough to justify its use as a definitive diagnostic tool in those cases in which tissue diagnosis is not possible.
A Comparative Study of Diagnostic Utility of Bronchial Washings And Brushings.
IOSR Journals , 2019
Background: Bronchoscopic materials are commonly subjected to cytological evaluation whenever there is a suspicion of malignancy. Radiological evidence of a mass and direct visualization of the lesion through a bronchoscope are not definitive evidence of malignancy. Further investigation when cytological material is positive for malignant cells gives the treating clinician an edge in early treatment of lung malignancies. An elaborate search of literature regarding various methods employed during bronchoscopy opined different combinations of cytological materials along with biopsy. However bronchial washings and brushings have been commonly preferred by many clinicians as well as pathologists. In view of compliance and to some extent cost effectiveness in investigations, this study aims at evaluating the superiority between bronchial washings and brushings. Objectives: The objective of the study are 1. To assess the diagnostic utility of bronchial washings and brushings in diagnosing various pulmonary lesions. 2. To evaluate the cytological pattern of various lung pathology in bronchial washings and brushings. 3. To identify the pitfalls in diagnosis by bronchial washings and brushings. Materials & Methods: The present study was carried out in Govt. Medical College Jammu, Department Of Respiratory Medicine, cover a period of 2 years from May 2017 to May 2019.(one year retrospective i.e from May 2017 to May 2018 and one year prospective, i.e From June 2018 to May 2019) which included a total of 100 cases. All patients were clinically and/or radiologically suspected to have a malignant lung lesion. Both bronchial washings and brushings were collected and sent to the department of pathology for cytological evaluation. Bronchial washings were centrifuged and precipitant material was smeared, wet fixed and air dried. Wet fixed smears were stained with papanicaloau stain and air dried smears with Leishman’s stain. Bronchial brushings were sent smeared on slides, wet fixed and air dried and similarly stained. The findings were tabulated, analyzed and statistically evaluated. Results: Comparing the positivity between the bronchial washings and brushings, bronchial brushings show 63.2% and bronchial washings show 18.4% positivity. The statistical analysis by McNemar’s Test reveals a p value of < 0.001(highly significant). Conclusion: This study reveals that the bronchial brushings are more reliable in diagnosis of malignancy than bronchial washings. In view of higher positivity in future, bronchial brushings can be very useful in early detection of lung cancer by using molecular techniques. Thus it can be costeffective with early confirmatory diagnosis.
The use of cytological methods in the diagnosis of malignant lesions of the respiratory tract has been generally acclaimed as one of its most successful applications. Flexible fiberoptic bronchoscopy revolutionized respiratory cytology, as bronchial brushings, broncho-alveolar lavage and bronchial forceps biopsy became more easy, accessible and popular, shifting the emphasis from diagnosis of advanced malignancy in inoperable patients to the use of cytology as a first line diagnostic and management tool. Respiratory tract cytology is well established throughout the world as a diagnostic procedure in the evaluation of patient with suspected lung malignancy. Methodology: The present study compromises of bronchoscopic cytology and histology of bronchial biopsy in 80 patients suspected of lung tumors. The study was carried out in the department of pathology M.P. shah medical college and the samples of the bronchoscopic material were received from tuberculosis and chest department of G.G hospital Jamnagar. Results: Out of 80 patients 66 were found to be malignant. Some of the suspicious lesions turned out to be malignant in biopsy. In the carcinoma of lung squamous cell carcinoma was the most common carcinoma (39.39% ) followed by adenocarcinoma (21.21%) small cell carcinoma 13.63% and large cell carcinoma 7.57 %, majority of the cases 77.5 % were male predominat. Conclusion: Pulmonary cytology is an important, basic diagnostic tool for the detection of lung cancer, that too in early diagnosis. Fibroptic bronchoscopy is an easy, OPD procedure which is minimally invasive and without any risk. It provides direct visualization of respiratory tract as well as lesion proper and variety of specimens can be collected.