Correlation of Fine Needle Aspiration Cytology With Bronchoalveolar Lavage and Brush Smear Cytology in Pulmonary Lesions

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 correlated well with FNAC for diagnosis of lung cancers.

Cytopathology of pulmonary lesions: A tertiary care center experience

“…A study conducted by Rohtagi et al . [ 7 ] found TB as the commonest specific benign lesion in concordance with our observation. Frequency of TB in patients being evaluated for pulmonary mass lesions ranges from 2 to 12% in various studies.…”

A cytological comparison of efficacy of bronchioalveolar lavage, transbronchial needle aspiration and image guided fine needle aspiration for diagnosis of pulmonary lesions in a rural tertiary care centre

“…The present study was done on 100 cases of pulmonary lesions using various cytological techniques. The mean age of the patients under study was 53.14 years which is comparable to studies done by Sareen et al, 3 Bhat et al 4 and Rohtagi et al 12 There was male preponderance of pulmonary lesions as mentioned by majority of the studies of the literature. The male: female ratio of present study was 2.7:1.…”

“…10 BAL via a flexible bronchoscope was introduced by Reynolds and Newball in 1974 as a therapeutic procedure for clearing secretions in the alveolar spaces. 11,12 Subsequently, the technique has been used as diagnostic procedure for confirmation of pulmonary infections particularly in immunocompromised individuals and interstitial lung diseases, thereby replacing the need of open biopsy. 13 These cytological procedures are easily performed and well tolerated for routine assessment of the patients with lung lesions.…”

Lung cancer cytology: Can any of the cytological methods replace histopathology?

“…In various studies from literature the values of sensitivity, specificity, and overall accuracy of BB are 63.0%–-87.3%, 75%–100%, and 65.67%–93.9%, respectively. [ 4 9 10 11 12 13 14 15 ] PPV and NPV vary from 95.65% to 100% and from 12% to 80.77%, respectively. [ 4 10 11 ] Our results confirmed the better diagnostic effectiveness of BB compared to BW.…”

“…[ 4 9 10 11 12 13 14 15 ] PPV and NPV vary from 95.65% to 100% and from 12% to 80.77%, respectively. [ 4 10 11 ] Our results confirmed the better diagnostic effectiveness of BB compared to BW. However, as in the case of BW, in our study the sensitivity of BB (32.14%) was lower than in the cited publications while other diagnostic parameters were consistent with those from the above research.…”