Cyto-Histological Evaluation of Bronchial Brushing, Bronchial Washing and Bronchial Biopsy in Lung Tumours
A Prospective Study From Tertiary Care Centre in Southern Rajasthan
Keywords:
Bronchial brushing, Bronchial washing, Bronchial biopsy, Fiberoptic bronchoscopy, Lung cancer
Abstract
Background: Lung cancer is the most frequently diagnosed major cancer in the world with a high mortality rate because most of the cases are diagnosed in advanced stage therefore early diagnosis of lung cancer is crucial in management. Examination of specimens obtained through flexible fiberoptic bronchoscope is an important and often the initial diagnostic technique performed in patients with suspected lung carcinoma. A study on cyto histological evaluation of bronchoscopic procedure samples was carried out to find out the efficacy of the procedures in lung tumours in southern Rajasthan. Methods: Bronchoscopy was performed in total 100 patients with clinico- radiological suspicion of lung cancer. Bronchial brushing, washing and biopsy were taken wherever possible. Cytology and biopsy samples processed and slides prepared for examination. Result: Overall sensitivity and specificity of bronchial brushing was 85.3% and 56.25% while for wash/BAL (bronchoalveolar lavage) the values were 78.34% and 59.26% respectively. Bronchial brushing had higher sensitivity for central as well as peripheral tumours while wash/BAL had higher sensitivity as well as specificity for peripheral tumours. Conclusion: Bronchial brushing and wash/BAL has excellent sensitivity and good specificity and yields almost same information as biopsy. But regarding histological typing of lesions, biopsy is more effective than cytological study. Therefore, all these techniques may be used concurrently to diagnose the lung tumours.References
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2. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA. Cancer J. Clin 2014; 64 (1): 9-29.
3. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90.
4. The Health Consequences of Smoking: A Report of the Surgeon General. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Washington, DC 2004. CDC Publication No. 7829.
5. Magrath I, Litvak J. Cancer in developing countries opportunity and challenge. J. Nat. Cancer, Itrt. 1993;85(ll):862-74.
6. Prabhat Singh Malik & Vinod Raina. Editorial: Lung cancer: Prevalent trends & emerging concepts. Indian J Med Res 141, January 2015,pp 5-7.
7. Bodh A, Kaushal V, Kashyap S, Gulati A. Cytohistological correlation in diagnosis of lung tumors by using fiberoptic bronchoscopy: Study of 200 cases. Indian J Pathol Microbiol. 2013;56:84-8.
8. Kotadia TP, Jasani JH, Vekaria PN. Comparison of bronchial biopsy, broncho alveolar lavage (BAL), brush cytology and imprint cytology in suspected cases of lung cancer International Journal of Biomedical and Advance Research. 2013:04(09):580-4.
9. Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y. The new world health organization classification of lung tumours. Eur Respir J. 2001;18:1059-68.
10. Behera D, Balamugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci 2004;46:269-81.
11. Guidelines of the Papanicolaou Society of Cytopathology for the examination of cytologic specimens obtained from the respiratory tract. Papanicolaou Society of Cytopathology Task Force on Standards of Practice. Diagn Cytopathol 1999;21:61-9.
12. Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: Summary of published evidence. Chest 2003;123:115S-28.
13. Gaur DS, Thapliyal NC, Kishore S, Pathak VP; Efficacy of broncho-alveolar lavage and bronchial brush cytology in diagnosing lung cancers; Journal of Cytology 2007; 24 (2) : 73-77.
14. Rivera MP, Detterbeck F, Mehta AC, American College of Chest Physicians. Diagnosis of lung cancer: The guidelines. Chest 2003; 123:129S-36.
15. Navneet S, Ashutosh NA, Dheeraj G, Digambar B, Surinder KJ. Quantified smoking status and non-small cell lung cancer stage at presentation: analysis of a North Indian cohort and a systematic review of literature. J Thorac Dis 2012;4(5):474-484.
16. Dhanalakshmi S, Priyadharshini M, Narmadha, Manibharathi R. Cytohistological Correlation of Fibreoptic Bronchoscopy Specimens with Added Value of Immunohistochemistry in Diagnosis of Lung Tumors. IOSR Journal of Dental and Medical Sciences. Volume 16, Issue 8 Ver. I (Aug. 2017), PP 18-21
17. Nazia B, Mir JN, Humaira B, Nusrat B, Summiya F, Kaneez F, Khalil MB. Correlation of bronchial biopsy with bronchoalveolar lavage in lung malignancies. Int J Res Med Sci. 2016 Feb;4(2):428-435.
18. Ruchee K, Deepti A, Akriti A and Kriti A. Usefulness of Bronchial washings in diagnosing lung malignancy. International Journal of Biomedical and Advance Research 2018; 9(3): 80-84.
19. Valaitis J, Warren S, Gamble D (1981). Increasing incidence of adenocarcinoma of the lung. Cancer,47,1042-6.
20. Wahbah M, Boroumand N, Castro C, El-Zeky F, Eltorky M. Changing trends in the distribution of the histologic types of lung cancer. A review of 4, 439 cases. Ann Diagn Pathol. 2007;11:89.
21. Prabhat SM, Mehar CS, Bidhu KM, N K Shukla, SVS Deo, Anant M, Guresh K, Vinod R. Clinico-pathological profile of lung cancer at AIIMS: A changing paradigm in India. Asian pacific journal of cancer prevention, Vol 14,2013.
22. Mathan RS., Sowmiya M. Does a routine post brush bronchial wash increase the yield in diagnosis of lung cancer? Int J Res Med Sci. 2017 Jul;5(7):2878-2882.
23. Shagufta TM, Ghadeer AM. Diagnostic value of bronchial wash, bronchial brushing, fine needle aspiration cytology versus combined bronchial wash and bronchial brushing in the diagnosis of primary lung carcinomas at a tertiary care hospital. Biomedical Research (2015) Volume 26,Issue 4.
24. M. Ahmad, S. Afzal, W. Saeed, A. Mubarik, N. Saleem, S. A. Khan, S. Rafi. Efficacy of Bronchial Wash Cytology and its correlation with Biopsy in Lung Tumours. JPMA 54:13;2004.
25. Raiza D, Rout S, Reddy KP, Ramalaxmi P, Prithvi BK, Harikishan KS. Efficacy of bronchial wash and brush cytology and its correlation with biopsy in lung lesions. IJHRMIMS. 2014 Oct;1(1): 21-24
Published
2020-03-11
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