Cytohistological correlation in diagnosis of lung tumors by using fiberoptic bronchoscopy: Study of 200 cases.

ABSTRACT

Background: Examination of specimens obtained through fl exible fi beroptic bronchoscope is an important and often the initial diagnostic technique performed in patients with suspected malignant lung lesion. Aims: To evaluate the correlation of cytological fi ndings of bronchial washings, bronchial brushing and imprint smear of bronchial biopsy in the diagnosis of lung tumors, with histopathology of bronchial biopsy taking the latter as the confi rmatory diagnostic test. Materials and Methods: A total of 200 patients with lung mass were included in the study. Bronchial brushings were obtained from all 200 cases. In the fi rst 100 cases, pre-biopsy bronchial washing (washing collected before the brushing and biopsy procedure) while post-biopsy washing (washing at the end of the procedure) was procured in all 200 cases. Imprint smears of bronchial biopsy were prepared in 150 cases. Results: Sensitivity and specifi city of brushing was 76.58% and 77.78% respectively and that of imprint smear was 81.35% and 78.12% respectively. Pre-biopsy and post-biopsy washing showed high specifi city of 88.89%, but low sensitivity of 30.14 and 36.77% respectively. No signifi cant difference was found in sensitivity between brushing and imprint smear (Chi-square; P = 0.4187); and between pre-biopsy and postbiopsy washing (Chi-square; P = 0.7982). However, there was a signifi cant difference between sensitivity of brushing and washing (Chi-square; P = 0.0001). The sensitivity of combination of three cytological diagnostic techniques was 87.29%. Conclusion: Bronchial brushing and washing cytology in combination with imprint cytology aids in the diagnosis of lung tumors. Therefore, all these techniques may be used concurrently along with bronchial biopsy to diagnose lung tumors.