Histopathological patterns of endobronchial lesions and the role of flexible fiberoptic bronchoscopy in their diagnosis

Abstract

Background Flexible bronchoscopy has become the most commonly used invasive procedure in pulmonary medicine used for diagnosis of multiple lesions of respiratory system presenting as endobronchial mass lesions, either benign or malignant in nature.Aim The aim was to detect the histopathological patterns of endobronchial lesions and the role of flexible bronchoscopy in their diagnosis.Patients and methods This is a retrospective study of bronchoscopy reports especially with endobronchial mass lesions diagnosed by fiberoptic bronchoscopy, which was performed at Chest Department, El-Hussein University Hospital, Al-Azhar University, over a period of 5 years from January 2012 to December 2016.Results The fiberoptic bronchoscopy was helpful in the diagnosis of endobronchial mass lesions in 65 (28.7%) patients of 350 patients who underwent bronchoscopy during this period. Their age ranged from 15 to 80 years. The patients comprised 35 males and 30 females. Overall, 42 (65%) lesions were malignant, 18 (28%) lesions were benign, whereas five (7%) lesions were inconclusive. Diagnostic yield was ∼92.3%. Repeat bronchoscopy for inconclusive results improved the diagnostic yield.Conclusion Fiberoptic bronchoscopy is the most important tool in pulmonary medicine used in the diagnosis of malignant as well as benign lesions that present as endobronchial mass lesions that mimic each other on visual impression, and thus adequate sampling is an essential diagnostic modality for confirming the diagnosis of such lesions.