Bronchoscopic Evaluation in Clinically and Radiologically Suspected Lung Carcinoma

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BACKGROUNDLung 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. METHODSThe 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. RESULTSOf 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. CONCLUSIONSLung 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.

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