Correlation of bronchial brushing cytology with bronchial biopsy in diagnosis of lung cancer

Abstract

Introducti on: Lung cancer is one of the leading cause of death in western countries and is the second most common malignancy in Nepal. Fiberopti c bronchoscopy has an excellent result in diagnosis of lung cancer when combined with brushing cytology & biopsy. This prospecti ve study was conducted at Tribhuvan University Teaching Hospital over the period of one year with the aim to correlate brushing cytology with biopsy in diagnosis of bronchoscopically visible lung cancer.Method: A total of 62 cases were included in this study on whom bronchoscopy was performed in endoscopy unit. Bronchial brushing, biopsy specimens were collected & processed accordingly. Results:Out of 62 cases, 53 were found to be malignant and 9 were infl ammatory lesions. Thus, cytohistological correlati on was done in 53 malignant cases. There were 38 male and 15 were female with a mean age of 54 years. The male:female rati o was 2.5:1.The most common type of carcinoma was squamous cell carcinoma (64.2%), followed by adenocarcinoma (18.8%), small cell carcinoma(13.2%), large cell carcinoma (1.9%), carcinoid tumor(1.9%). Sensiti vity of the bronchial brushing was 94.6% while that of biopsy was 91.3%. Conclusion:Bronchial brushing cytology has bett er detecti on rate than biopsy in this study. However combinati on of these modaliti es gives higher detecti on rate for bronchoscopically visible tumor. Therefore, bronchial brush cytology should be performed whenever possible in all suspected cases of lung cancer.

Sensitivity of Bronchial Biopsy Versus Bronchial Washings and Brushings in Cases of Collapse

“…5 When biopsy is difficult in certain anatomical location of the lesions and in haemorrhagic disorders, brushing cytology can be considered as an effective tool to diagnose the condition as it covers wider area (2 cm) compared to less than 5 mm by forceps and it is easy to obtain brushing cytology sample. 6 Imprint smears from bronchial biopsy has also been found to give a good diagnostic yield. 7 Better diagnostic yield is often obtained when cytologic techniques are used together with bronchial biopsy.…”