Role of Bronchial Brush Cytology in Diagnosis of Central Bronchial Carcinoma (original) (raw)
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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.
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.
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.
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.
Original Article Efficacy of Bronchial Wash and Brush Cytology and its correlation with
Back ground : Lung cancer is the commonest cause of cancer related deaths worldwide. So early diagnosis and management is the key to prevent mortality. Bronchoscopic guided washing and brushing can complement histological biopsy in early diagnosis as it is having good cytological yield. The aim of this study is to evaluate the efficacy of bronchoscopic washings, brushings and its correlation with subsequent biopsy in diagnosing lung lesions. Materials and methods : Prospective study of 38 cases from 20 to 70yrs of age was conducted in department of pathology, MIMS from Jan 2013 to Dec 2013. They had visible endobronchial lesions by flexible bronchoscopy and subjected to cytological washing and brushing study and subsequent biopsy. Cytological and biopsy specimens were fixed in isopropyl alcohol and formalin respectively and stained with Hemotoxylin & Eosin stain. Results : Cytology revealed 12 malignant,13 benign,5 suspicious and 2 inadequate smears respectively. Histopathology of these cases confirmed 23 as malignant and 14 as benign. True positive were 16 and true negative were 13 cases. 1 false positive case and 6 false negative cases were reported. The bronchial wash cytology showed sensitivity of 80.5%, specificity of 92.85% and accuracy of 80.5%. Conclusion : Bronchial cytology is a valuable tool and yields almost same information as biopsy.
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.
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...
Efficacy of bronchial brushings and trans-bronchial needle aspiration in diagnosing carcinoma lung
Journal of Cytology, 2007
Bronchial brushing (BB) and the more recent trans-bronchial needle aspiration (TBNA) are well established techniques performed using flexible fiberoptic bronchoscope, for sampling trachobronchial lesions suspected of malignancy. Our aim was to assess the efficacy of these two techniques in diagnosing carcinoma lung, when used individually as well as in combination, taking bronchial biopsy as the "Gold Standard" diagnostic test. Of all the cases of suspected lung cancer 181 cases were selected where flexible bronchoscopic samples of BB, TBNA as well as bronchial biopsy were taken. Samples were processed as per standard procedures of cytology and histology. Squamous cell carcinoma was the most common lung cancer followed by small cell type. Sensitivity of BB was 81.5%; while that of TBNA was 62.5%. Specificity of BB and TBNA was 77.8% and 66.7%, respectively. Efficacy of BB was better than TBNA in diagnosing lung cancers. Combined use of BB and TBNA showed better sensitivity and accuracy than either techniques used individually. Bronchial brushing is a superior technique in the diagnosis of lung cancers than TBNA. Their combined use can further improve the chances of early detection of lung cancers. Journal of Cytology 2007; 24 (1) : 46-50