Comparison of bronchial biopsy, broncho alveolar lavage (BAL), brush cytology and imprint cytology in suspected cases of lung cancer (original) (raw)
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Bronchoscopic Evaluation in Clinically and Radiologically Suspected Lung Carcinoma
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Lung cancer is generally diagnosed during late stage of the disease; so, early diagnosis of lung cancer is very important to reduce lung cancer death rate. Flexible fibreoptic bronchoscopy (FOB) is an important diagnostic technique performed in patients with suspected malignant lung lesion as it provides sufficient cytologic and histologic specimens in the form of bronchial washing, bronchial brushing and bronchial forceps biopsy. METHODS The present descriptive study analysed cytology of bronchial washing, bronchial brushing and histology of bronchial biopsy in 100 patients with suspected lung cancer. Patients in whom clinical and radiological findings suggested lung carcinoma, were included in the study. Patients with coagulopathy, refractory hypoxemia, cardiac instability, poor ability to cooperate with the procedure were excluded from this study. Age, gender, smoking habits, clinical and radiological findings, various histological types of malignancies, and yield of various bronchoscopic diagnostic techniques in the diagnosis of lung cancer were evaluated. RESULTS Of the 100 cases, 86 (86%) were males and 14 (14%) were females with male to female ratio of 6.14:1. The mean age in this study group was 58 years. Overall diagnostic yield by means of all techniques during bronchoscopy was 90% (90/100 patients). Squamous cell carcinoma was the most common primary bronchogenic tumour 36.67% (33/90 patients) followed by Adenocarcinoma 25.56% (23/90 patients), small cell carcinoma 24.44% (22/90 patients), Undifferentiated Non-Small Cell Carcinoma (NSCLC) 12.22% (11/90 patients), poorly differentiated carcinoma 1 patient. No evidence of malignancy was found in 10 patients by all techniques during bronchoscopy. CONCLUSIONS Lung cancer is a common malignancy with male preponderance. Bronchial washing and brushing cytology in combination with bronchial biopsy has a very high diagnostic yield. Therefore, all these techniques may be used concurrently to diagnose lung 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.
IP innovative publication pvt. ltd, 2019
Introduction and Aim: Bronchoscopy is highly sensitive investigation for patients with suspected lung malignancy. Beside histology, a cytological diagnosis is also possible with the help of bronchoscopy. In present study, we describe our experience of performing bronchoscopy in patients with suspected lung cancer. Materials and Methods: Present study was prospective observational study done over a period of one year at a tertiary care centre of western India. In this study 75 patients were recruited in the study that had suspected lung cancer and subjected to bronchoscopy also. A detailed clinical history, physical examinations was done before hand and necessary investigations were also done. Selected patients with chest x-ray and CT scan and clinical findings consisting with lung cancer were subjected for flexible fiberoptic video bronchoscopy after obtaining well informed written consent. Result: Most of the patients were between 51-70 years of age. 59 patients were male, and 16 patients were female. Bronchoalveolar lavage (BAL) was performed in all patients and given positive result in 42 patients. Yield of BAL was 56.0%. Endo-bronchial biopsy was performed in 58 patients and gave positive result in 47 patients. Yield of Bronchial biopsy was 81.03%. Adenocarcinoma was commonest type present in 40% of participants, while second most common was Squamous cell carcinoma. Small cell carcinoma was present in 4.%, Large cell carcinoma in 1% and Undifferentiated carcinoma in 12% of patients. Conclusion: Premature recognition of lung cancer in the airway is vital for evading the multi-step sequence to invasive cancer. Though tissue biopsy is the gold standard for diagnosing neoplastic and preneoplastic disease, bronchoscopic technologies are the safest and most precise tools to assess both central and distal airway mucosa.
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...
Journal of Kathmandu Medical College, 2018
Background: Flexible bronchoscopy is the main modality of diagnosing lung malignancy as per the location of lesion in our setup. Accurate diagnosis and categorization into various types is vital for its prognostic and management point of view. Objectives: The study was conducted to find out yield of bronchoscopy and FNAC in suspected lung lesion and to know the various subtypes of bronchogenic carcinoma. Methodology: The study was conducted in Kathmandu Medical College Teaching Hospital from December 2016 to May 2018. This was a prospective observational study conducted in 90 radiological suspected lung lesions. Radiological, bronchoscopy, histopathological and cytopathological findings were analyzed and evaluated. Data were recorded on a pre-designed proforma and entered into Statistical Package for the Social Sciences version 20. Results: Among 90 suspected lung lesions who underwent contrast enhanced computed tomography, chest mass lesion was seen in 57(63.3%) subjects, nodular i...
Diagnostic Procedures for Lung Cancer According to Histological Types and Their Complications
Cyprus Journal of Medical Sciences, 2021
BACKGROUND/AIMS This study aimed to investigate if there are any differences between the diagnostic methods used in biopsy for lung cancer on the basis of the histological cell types. In addition, the contribution of bronchoscopic washing in the diagnosis of lung cancer and complications of flexible bronchoscopy and computed tomography (CT)-guided transthoracic needle biopsy (TNB) were also investigated. MATERIAL and METHODS The patients who were diagnosed with lung cancer pathologically were divided into two groups-bronchoscopic biopsy and CT-guided TNB. A comparison was made between the two groups according to the lung cancer cell type. Complication rates for both procedures were calculated. In addition, the contribution of bronchoscopic washing in the diagnosis of lung cancer was also investigated in patients who underwent bronchoscopy. RESULTS The study included 182 lung cancer patients, out of whom 106 patients were diagnosed by bronchoscopy and 76 patients were diagnosed by CT-guided TNB. There was no significant difference between the diagnostic approaches for adenocarcinoma (ADC) (p=.22). Small cell lung cancer (SCLC) and squamous cell carcinoma (SCC) were diagnosed more accurately by bronchoscopy than TNB (p=.01, p=.01, respectively). Bronchoscopic washing was found to be positive in 3 of the patients who had negative results with bronchoscopic biopsy. There were no major complications related to bronchoscopy. The total minor complication rate of bronchoscopy was found to be 11.3%. Pneumothorax was detected in 17% of patients undergoing TNB and the total complication rate of TNB was 19.7%. CONCLUSION SCLC and SCC were more accurately diagnosed by flexible bronchoscopy than TNB. Bronchoscopic washing contributed in the diagnosis of lung cancers. Flexible bronchoscopy was found to be much safer and associated with lower complication rates than CT-guided TNB.
Indian Journal of Pathology and Oncology, 2020
Background: The diagnostics in field of lung pathology with advent of bronchoscopic modalities comprises of BAL, BB, TBNA and TBLB. As the detection of malignancy at the earliest has taken so much importance in terms of treatment, prognosis and life expectancy use of cytological bronchoscopic modalities have come to an age and has promised early, accurate diagnosis and better patient outcome. In India as cases of lung diseases continues to increase, the use of cytology has a special role and in particular neoplastic lesions, infectious diseases and in ILD cases. TBNA technique should be encouraged due to its superior sensitivity. Materials and Methods: This study of BAL, BB, TBNA was done during routine diagnostic bronchoscopies at Government tertiary care centre and comparing their results with TBLB as gold standard. The study consisted of clinically diagnosed / suspected cases of lung lesions. The BAL/TBNA/BB cytology and TBLB specimens were taken by the pulmonologist. The clinica...