Bronchoscopic Evaluation in Clinically and Radiologically Suspected Lung Carcinoma.

Lung cancer is generally diagnosed during late stage of the disease; so, early diagnosis of lung cancer is very important to reduce lung cancer death rate. Flexible fibreoptic bronchoscopy (FOB) is an important diagnostic technique performed in patients with suspected malignant lung lesion as it provides sufficient cytologic and histologic specimens in the form of bronchial washing, bronchial brushing and bronchial forceps biopsy.METHODSThe present descriptive study analysed cytology of bronchial washing, bronchial brushing and histology of bronchial biopsy in 100 patients with suspected lung cancer. Patients in whom clinical and radiological findings suggested lung carcinoma, were included in the study. Patients with coagulopathy, refractory hypoxemia, cardiac instability, poor ability to cooperate with the procedure were excluded from this study. Age, gender, smoking habits, clinical and radiological findings, various histological types of malignancies, and yield of various bronchoscopic diagnostic techniques in the diagnosis of lung cancer were evaluated.RESULTSOf the 100 cases, 86 (86%) were males and 14 (14%) were females with male to female ratio of 6.14:1. The mean age in this study group was 58 years. Overall diagnostic yield by means of all techniques during bronchoscopy was 90% (90/100 patients). Squamous cell carcinoma was the most common primary bronchogenic tumour 36.67% (33/90 patients) followed by Adenocarcinoma 25.56% (23/90 patients), small cell carcinoma 24.44% (22/90 patients), Undifferentiated Non-Small Cell Carcinoma (NSCLC) 12.22% (11/90 patients), poorly differentiated carcinoma 1 patient. No evidence of malignancy was found in 10 patients by all techniques during bronchoscopy.CONCLUSIONSLung cancer is a common malignancy with male preponderance. Bronchial washing and brushing cytology in combination with bronchial biopsy has a very high diagnostic yield. Therefore, all these techniques may be used concurrently to diagnose lung malignancy.

Unilateral lung hypoplasia: A rare cause of unilateral opaque hemithorax in chest X-ray in a young boy.

Congenital abnormalities of lung are very rare entity, and very often under or misdiagnosed by physicians. The present case, a 12-year boy, who was initially diagnosed as unilateral massive pleural effusion with collapse of lung, and after thorough investigation, including CT scan of thorax, fiber-optic bronchoscopy, and echocardiography, a final diagnosis of unilateral lung hypoplasia was made. So if a teenager present with a unilateral opaque hemithorax in chest X-ray, this entity may be a differential diagnosis.

Transthoracic cutting needle biopsy: a valuable diagnostic procedure.

Intrathoracic mass lesions, especially peripherally situated masses, often present as a problem as tissue diagnosis is not always possible by cytopathological examination. Cutting needle biopsy may be the method of choice in selected cases for tissue diagnosis. Cutting needle biopsy is indicated for patients with peripherally situated mass lesions abutting chest wall, which are non-vascular and non-cystic in nature.

Plasma cell granuloma of lung.

A 10 years old girl presented with fever, cough, haemoptysis, dyspnoea on exertion of two months duration. Chest skiagram and CT-scan of thorax revealed well defined mass lesion of varying density occupying right upper and middle lobes with areas of calcification. On thoracotomy, a huge mass in the right upper lobe was resected and hispathological examination proved it to be a case of plasma cell granuloma.