Value of washings and brushings at fibreoptic bronchoscopy in the diagnosis of lung cancer.

Abstract

A retrospective study was performed to evaluate the diagnostic yield for lung cancer from histological biopsy specimens and from washings and brushings for cytological examination taken at fibreoptic bronchoscopy. The Any patient with an inadequate follow up (because of lost records, for example) or with insufficient data was excluded from the study.The two most common reasons for bronchoscopy were an abnormal chest radiograph (493 cases) and haemoptysis (104 cases). Other reasons for bronchoscopy included dyspnoea, stridor, chronic cough, and hypercalcaemia of unknown cause.Because this was a restrospective study, all combinations of cytological and histological procedures were found to have been used. In most cases, however, washings, brushings, and biopsy specimens were taken, especially when a tumour was visible. The sequence when all three procedures were performed was always washing, biopsy, and then brushing immediately before extraction of the bronchoscope. Washings were obtained by lavage with 20-40 ml of normal saline and aspiration into a trap. No set number of biopsy specimens was taken.When no lesion was seen endoscopically, "blind" cytology was performed by lavaging as described and brushing the appropriate segment as determined by the posteroanterior and lateral chest radiographs. Occasionally "blind" biopsy was also performed, the biopsy forceps being directed into the appropriate segment.Brushings were smeared on to two to four slides and immediately fixed in 9500 alcohol. Washings were taken to the cytology laboratory and centrifuged at 1500 rev/min for five minutes, the supernatant was poured off, and the sediment of material was pipetted on to several slides and fixed with 95% alcohol.Cytological specimens were stained routinely by the Papanicolaou technique. Specimens were interpreted by the cytopathologist with-

Endoscopia respiratória em 89 pacientes com neoplasia pulmonar

“…No entanto, o adenocarcinoma predominou no gru-Endoscopia respiratória em 89 pacientes com neoplasia pulmonar po 2, que foi de 27,7% contra 7,5% no grupo 1, enquanto o carcinoma indiferenciado de pequenas células predominou no grupo 1 com 13,2% e 5,5% no grupo 2. Esses dados concordam com vários autores (4,8,(19)(20)(21)(22)(23) , que em suas séries descrevem carcinomas epidermóides e indiferenciado de pequenas células como lesões visíveis à endoscopia por serem mais centrais. Já os adenocarcinomas, por ser mais periféricos (4,8,22) , não são visíveis à endoscopia ou se apresentam como sinais indiretos de tumor.…”

Assessment of Diagnostic Accuracy of Bronchoalveolar Lavage Cytology in the Diagnosis of Lung Tumors and Contribution to the Classification of Non-Small Cell Lung Cancer Entities: A Retrospective Clinocopathological Study

“…Naryshkin et al, who examined the reliability of bronchoscopic cytology in relation to biopsy, found a rate of 10.7% of nondiagnostic biopsies [23]. Some other studies have demonstrated diagnostic rates of 9.5% and 2.1% for bronchial washing (without histological confirmation), respectively [24,25]. We identified 54/678 (8.0%) cases in which only cytology was diagnostic or generated an abnormal result leading to further investigation.…”

Diagnostic yield of conventional transbronchial needle aspiration in suspected bronchogenic carcinoma without intraluminal growth on bronchoscopy

“…While the diagnostic yield for washings in patients with endoscopically visible (central) tumors varies from 49 to 76% and is similar to the yield for brushings (52 to 77%) but is inferior to the yield of biopsies (71 to 91%); the efficacy of washings in patients with endoscopically nonvisible (peripheral) tumors, varies from 35 to 52% and is similar to the yield for brushings (26 to 52%) and for biopsies (36 to 61%). [11][12][13][14] Some studies have reported that adding bronchial washings to biopsies and brushings increases the diagnostic yield; whereas others, have reported no additional value of washings. 12,13,[17][18][19][20] In the present study, bronchial washing successfully detected lung carcinoma in a single patient alone, and a sensitivity as low as 3.4%, was obtained.…”