Diagnostic evaluation of fine needle aspiration biopsy in lung cancer

To evaluate the yield of Fine Needle Aspiration Cytology [FANC] in suspected lung cancer. Observational study. This study was conducted at the Department of Pulmonology, Bolan Medical College Quetta from Jan 2009 to Aug 2009. Thirty Cases both male and female were included in the study. The lesion was localized with recent PA and Lateral Chest X-Rays and ultra sound. A 22 guage needle was attached to 10cc syringe. The needle was introduced into the lesion under local anaesthesia. On reaching the mass slight suction was applied and few in and out movements were made, the needle was taken out and 3-4 slides were made of the aspirate, fixed immediately with alcohol. Among thirty cases, malignancy was proved in 21 cases while in 3 cases FNAC was positive for malignancy but no call type was revealed. In six cases malignancy was not found. Among proven 21 cases 14 had squamaus call carcinoma, 6 had Adeno carcinoma and one had small call carcinoma. FNAC of the peripheral lung lesions is a safe, quick and reliable method of establishing diagnosis of lung cancers where bronchoscopic help is not available or the tumor is not with in reach of bronchoscope

Allergic bronchopulmonary aspergillosis and bronchial asthma, a forgotten partners

To evaluate the incidence of ABPA [Allergic Broncho Pulmanary Aspergillosis] in Asthma. Observational Study. This study was conducted at Pulmonology Department, Bolan Medical College Quetta from 2005-2010. Forty Cases both male and female were included in this study. A detailed medical history, complete physical examination, recent posteroanteral and lateral chest X.Ray were obtained. Where ever possible previous X-Ray chest were also obtained for comparison and to see the fleeting shadows. Laboratory help included absolute eosinophil count, total serum IgE, Sputum for fungal hyphae and spirometry. Among forty [40] cases 90% were asthmatics between 11-40 years of age. In 92% of cases the radiological findings were fleeting in nature. 70% were misdiagnosed and treated as pulmonary tuberculosis. All 40 case had raised [70.5 x 10[9] perlitre] absolute eosinophil count in peripheral blood. Sputum eosinophilia was detected in 77% of cases and fungal hyphae were isolated in 47% cases bronchospy and serum IgE levels were also abnormal but performed in only 25% cases. ABPA must be considered in asthma patients having unexplained, fleeting or persistent chest radiographic shadows

Diagnostic yield of fibreoptic bronchoscopy in smear negative new cases of pulmonary tuberculosis

To assess the diagnostic yield of bronchial washings for detection of AFB in clinically suspected new smear negative cases of pulmonary tuberculosis. Non-interventional analytical Combined Military Hospital Quetta and Fatima Jinnah General and Chest Hospital Quetta, Pakistan. From outpatient departments of these two hospitals, fifty smear negative new cases of pulmonary tuberculosis [PTB] were included in whom diagnosis was made on the basis of clinical findings and x-ray. All these patients underwent fibrotic bronchoscopy for collection of bronchial washings from the lobe1 segment where lesions were evident on plain chest x-ray. These secretions were sent to microbiology department for preparation of smear and detection of acid-fast bacilli [AFB] with Zeihl- Nelson staining. Out of 50 patients, 33 [66%] were males and 17 [34%] were females. On smear of bronchial washings, 21 [42%] were positive for AFB while 29 [58%] were still negative. Bronchial washings were found to have better diagnostic yield of AFB on direct smears as compared to standard sputum smear examinations. Moreover, clinical suspicion of PTB is not always correct, as significant numbers of clinically suspected cases did not yield AFB in bronchial washings. Where feasible, fibreoptic bronchoscopy and direct washings should be employed for confirming the clinical impression of PTB in smear negative cases