January-March 2018

Audit of Fiberoptic Bronchoscopy Guided Cytologic Techniques, Year 2015-2016: Diagnostic Accuracies of Bronchalveolar Lavage, Bronchial Brushing and Transbronchial Needle Aspiration

Rami K1*, Chatterjee I2, Ghanchi F3, Patel I4

1Senior resident, 2Associate professor, 3Professor and Head, 4First Year Resident, Department of Pulmonary Medicine, Shri M.P.Shah Government Medical College, Jamnagar 361008


BACKGROUND: Early diagnosis of lung cancer plays a pivotal role in reducing lung cancer death rate. Bronchoscopic washing, brushing and transbronchial needle aspirations(TBNA) not only complement tissue biopsies in the diagnosis of lung cancer but also comparable. OBJECTIVE: To find out diagnostic yield of bronchoalveolar lavage, bronchial brushing and transbronchial needle aspiration in diagnosis and to compare relative accuracy of these three cytological techniques. MATERIAL AND METHOD: All patients who came with clinical or radiological suspicious of lung malignancy over a period of two years were included in study. Fiberoptic bronchoscopy was done and bronchoscopy guided bronchoalveolar lavage, brushing and transbronchial needle aspiration was taken. RESULT: The most sensitive technique was TBNA (100%), followed by bronchial brushing (79.39%) and BAL (70.37%). Specificity and positive predictive value were 100% for each of all techniques. CONCLUSION:  Fiberoptic bronchoscopy is an excellent tool to evaluate endobroncheal lesions. Bronchial brushing, BAL and TBNA are having high yield in diagnosing such lesions. TBNA allows sampling of subcarinal and paratracheal lymph nodes and thus helps in staging with minimal complications.

Keywords: Lung cancer, Fiberoptic bronchoscopy, bronchial brushing, BAL, TBNA

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