Cyto-Histological Evaluation of Bronchial Brushing, Bronchial Washing and Bronchial Biopsy in Lung Tumours A Prospective Study From Tertiary Care Centre in Southern Rajasthan

Jigyasu Joshi,Sunita Bhargava

doi:10.21276/apalm.2599

Abstract

Background: Lung cancer is the most frequently diagnosed major cancer in the world with a high mortality rate because most of the cases are diagnosed in advanced stage therefore early diagnosis of lung cancer is crucial in management. Examination of specimens obtained through flexible fiberoptic bronchoscope is an important and often the initial diagnostic technique performed in patients with suspected lung carcinoma. A study on cyto histological evaluation of bronchoscopic procedure samples was carried out to find out the efficacy of the procedures in lung tumours in southern Rajasthan. Methods: Bronchoscopy was performed in total 100 patients with clinico- radiological suspicion of lung cancer. Bronchial brushing, washing and biopsy were taken wherever possible. Cytology and biopsy samples processed and slides prepared for examination. Result: Overall sensitivity and specificity of bronchial brushing was 85.3% and 56.25% while for wash/BAL (bronchoalveolar lavage) the values were 78.34% and 59.26% respectively. Bronchial brushing had higher sensitivity for central as well as peripheral tumours while wash/BAL had higher sensitivity as well as specificity for peripheral tumours. Conclusion: Bronchial brushing and wash/BAL has excellent sensitivity and good specificity and yields almost same information as biopsy. But regarding histological typing of lesions, biopsy is more effective than cytological study. Therefore, all these techniques may be used concurrently to diagnose the lung tumours.

Highlights

Lung cancer or bronchogenic carcinoma, is a malignant lung tumour characterized by uncontrolled cell proliferation in lung tissue
Cytological assessment of specimens of the respiratory tract using flexible FOB is the most commonly used technique for the diagnosis of lung cancer. Both bronchial washing and brushing used concurrently are effective in the diagnosis of neoplastic lesions of lung
These tend to preserve both the cells and their architectural arrangement. This technique can be used in conjunction with radiological and histological findings to give 100% accuracy in the diagnosis of lung cancer

Summary

Introduction

Lung cancer or bronchogenic carcinoma, is a malignant lung tumour characterized by uncontrolled cell proliferation in lung tissue. It is the most frequently diagnosed cancer currently and the leading cause of the cancer related deaths across the world. The incidence of lung cancer is increasing globally and it has become the leading cause of death in most countries. Lung cancer is a highly lethal disease because majority of the patients are diagnosed in advanced stage when it has become incurable. Clinical outcome is significantly better in patients who are diagnosed at earlier stages when cancer is still confined within the lungs. A study on cyto histological evaluation of bronchoscopic procedure samples was carried out to find out the efficacy of the procedures in lung tumours in southern Rajasthan

Methods

Results

Discussion

Conclusion