English

Abstract

BACKGROUND: Fine Needle Aspiration Cytology (FNAC), Bronchoalveolar Lavage (BAL) and Brush Cytology are important diagnostic tools for evaluation of pulmonary lesions. Considering the limitations of these procedures correlation of these cytological techniques may help in improving accuracy and increasing the diagnostic yield. AIM: To determine the role of FNAC, Brush and BAL Cytology in pulmonary lesions and to correlate the efficacy of FNAC with Brush and BAL Cytology. MATERIALS AND METHODS: This prospective study was conducted on 78 patients with radiologically demonstrable pulmonary lesions in the department of pathology and Dr ML Chest Hospital, GSVM Medical College, Kanpur over a period from nov2011-july2013. The cases selected had to give consent for the procedure. Bronchoalveolar lavage, bronchial brush sample were taken and FNAC was done in the cases. RESULTS: In present study 78 cases of pulmonary lesions were subjected to FNAC and/ or Bronchoalveolar lavage and brush cytology. Among them 49 cases were selected in which all three procedures were done. The sensitivity and specificity for detecting lung tumors by FNAC was 96.29% and 95.45% which was more than that of BAL cytology (84.61%, 91.30%) and Brush cytology (81.48%, 95.45%). FNA correlates with Brush and BAL cytology in 78.57% of malignant lesions. Among malignant lesions 84.61% of BAL and Brush cytology correlates with FNA for diagnosis of squamous cell carcinoma. FNA correlates with 66.67% of brush and 83.37% of BAL fluid cytology for diagnosis of adenocarcinoma. BAL and Brush both correlates with FNA in 83.33% cases of small cell carcinoma. Overall 85.71% of BAL and 82.14% of brush smear cytology correlates with FNA cytology for diagnosis of lung cancers. CONCLUSIONS: FNA, BAL and Brush cytology provide a high yield for evaluation of pulmonary lesions. BAL fluid and brush cytology