Efficacy of Bronchial Wash Cytology and its Correlation with Histopathology in Diagnosis of Lung Carcinoma in a Tertiary Care Hospital
AbstractIntroduction: Cytological evaluation is an important, usually initial diagnostic modality in patients with suspected malignant lung masses. Bronchoscopic washing, bronchoalveolar lavage, bronchial brushing and fine needle aspirations may complement tissue biopsies in the diagnosis of lung cancer. This study was undertaken to compare the efficacy of bronchial wash cytology and to correlate it with histopathology in diagnosis of suspected cases of lung cancer at a tertiary care hospital. Material and methods: Bronchial washings and bronchial biopsy were collected from total 60 clinically suspected cases of carcinoma lung. Bronchial washing smears were stained with MGG and H&E stain and were categorized as unequivocally positive / unequivocally negative for malignancy and atypical (equivocal for diagnosis). Biopsy sections were examined for histopathological diagnosis. Results: Cytomorphologically, 30 cases were reported as positive for malignancy, 28 cases were negative for malignancy and 02 cases were atypical. On histopathology, lung carcinoma was diagnosed in 48 patients out of them 35 cases were of squamous cell carcinoma, 7 cases were of small cell carcinoma and 6 were of large cell carcinoma. Conclusion: Maximum diagnostic yield can be obtained by combining biopsy with cytological procedures of washing rather alone.
Myron R. Melamed, Leopard G Koss.In:Koss’ cytopathology.5th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
Ferlay J, Soerjomataram I, Ervik M. GLOBOCAN 2012 vl.0, Cancer Incidence and mortality worldwide: IARC Cancer Base No 11. International agency for research on cancer. GLOBOCAN 2013;2012VL.0.
Johnston WW, Elson CE. Comprehensive cytopathology.2nd ed. Philadelphia: W.B. Saunders Company;1997.
Young JA. Techniques in Pulmonary cytopathology. J Clin Pathol. 1993;46(7):589-95.
Mazzone P, Jain P, Arroliga AC, Matthay RA. Bronchoscopy and needle biopsy techniques for diagnosis and staging of lung cancer. Clin Chest Med. 2002;23(1):137-58.
Villara AF, Gonzálezb A, Leiroa V, Represasa C, Botanaa MI. Effect of Different Bronchial Washing Sequences on Diagnostic Yield in Endoscopically Visible Lung Bronconeumol. 2006; 42(6):278-82. DOI:10.1016/S1579-2129(06)60143-2.
Stewart BW, Kleihues P. World cancer report (World health organisation press, Geneva, 2003).
Noronha V, Pinninti R, Patil VM, Joshi A, Prabhash K. Lung cancer in the Indian subcontinent. South Asian J Cancer. 2016;5:95.
Wig KL, Lazaro EJ, Gadekar NG, Guleria JS. Bronchogenic carcinoma (clinical features and diagnosis). Indian J Chest Dis. 1961;3:209-18.
Rajasekaran S, Manickam TG, Vasanthan PJ. Pattern of lung cancer- A Madras study. Lung India. 1993;11:7-11.
Arora KV, Navjeevan S, Sujata C, Arati B. Significance of cytologic criteria in distinguishing small cell from non small cell carcinoma of the lung. Acta Cytol. 2003;47:216-20.
Ahmad M, Afzal S, Saeed W et al. Efficacy of Bronchial Wash Cytology and its correlation with Biopsy in Lung Tumours. Journal of Pakistan medical association. 2004;54(1):13-6.
Gaur DS, Thapliyal NC, Kishore S, Pathak VP. Efficacy of bronchoalveolar lavage and bronchial brush cytology in diagnosing lung cancers. J Cytol. 2007;24(1):73-7.
Buccheri G, Barberis P and Delfino MS. Diagnostic, morphologic, and histopathologic correlates in bronchogenic carcinoma. A review of 1,045 bronchoscopic examinations. Chest. 1991;99;809-14.
Jha VK, Roy DC, Ravindran P. Bronchogenic Carcinoma: A clinicopathologic study. Ind I Chest Dis. 1972;14:78-85.
Hecht SS. Tobacco smoke, carcinogens and lung cancer. J Natl. Cancer Inst. 1999;91(14):1194-1210.
Ochsner A. Bronchogenic carcinoma. A largely preventable lesion assuming epidemic proportions. Chest. 1971;59(4):358-9.
Jindal SK, Behara D. Clinical spectrum of pulmonary lung cancer; Review of Chandigarh experience of 10 years. Lung India. 1990;8:94-8.
Viswanathan R, Gupta S, lyer PVK. Incidence of primary lung cancer in India. Thorax. 1962;17(1):73-6.
Bhattacharya SK, Mandal A, Deoghuria D, Agrawal A, Alok GG, Dey SK. Clinicopathological profile of lung cancer in a tertiary medical centre in India: Analysis of 266 cases. Journal of Dentistry and Oral hygiene. 2011;3:30-3.
Kumar M, Sharma DK, Garg M, Jain P. Clinicopathological profile of lung cancer- changing trends in India. Int J Resp Med. 2016;5:57-62.
Piplani S, Mannan R, Lalit M, Manjari M, Bhasin TS, Bawa J. Cytologic-radiologic correlation using transthoracic CT-guided FNA for lung and mediastinal masses: our experience. Analytical Cellular Pathology. 2014;2014(34):1-6.
Jerse MJ, Tercelj M. Contributions of cytology examination and methods in lung cancer diagnosis. Radiol. 2006;40:S77-85.
Truong LD, Underwood RD, Greenberg SD, McLarty JW. Diagnosis and typing of lung carcinomas by cytopathologic methods. A review of 108 cases. Acta Cytol. 1985;29:379-84.
Tuladhar A, Panth R, Joshi AR. Comparative analysis of cytohistologic techniques in diagnoses of lung lesions. Journal of Pathology of Nepal. 2011;1:126-30.
Solomon DA, Solliday NH, Gracey DR. Cytology in fibreoptic bronchoscopy. Chest.1974;65(6):616-9.
Lam WK, So SY, Hsu C, Yu DY. Fiberoptic bronchoscopy in the diagnosis of bronchial cancer: Comparison of washings, brushings biopsies in central and peripheral tumors. Clin Oncol. 1983;9(1):35-42.
Mufti ST, Mokhtar GA. Diagnostic value of bronchial wash, bronchial brushing, fine needle aspiration cytology versus combined bronchial wash and bronchial brushing in the diagnosis of primary lung carcinoma at a tertiary care hospital. Biomedical Research. 2015;26:777-84.
Rao S, Lal A, Barathi G, Dhanasekar T, Duvura P. Bronchial wash cytology: A study on morphology and morphometry. J Cytol. 2014;31:63.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).