Study of diagnostic efficacy of bronchoalveolar lavage and bronchoscopic brush cytology in clinico-radiologically suspected cases of lung malignancies

Abstract

Background: Fibre-optic bronchoscopy (FOB), along with its guided procedures such as endobronchial biopsy, bronchial brushings, bronchoalveolar lavage (BAL), transbronchial needle aspiration and transbronchial lung biopsy, is the most widely used technique for the diagnosis of lung cancer. This study was undertaken to study the diagnostic efficacy of BAL and bronchoscopic brush cytology in clinico-radiologically suspected cases of lung malignancies, and compare them with biopsy, wherever possible. Methods: FOB was performed on 130 clinico-radiologically suspected cases of lung malignancy, reporting to our tertiary care centre. The samples obtained were sent for histological and cytological examination. Results: Bronchoscopic brushing and BAL was done in all the 130 patients and biopsy was performed in 65 cases. Out of these 130 cases, 100 were diagnosed to have lung malignancies giving an overall sensitivity of 76.92% for FOB. Of these 100 cases, 55 patients were detected by BAL alone and bronchial brushing alone diagnosed 80 cases. The most common histological subtype detected was squamous cell carcinoma (57%) followed by adenocarcinoma (24%). Biopsy had a sensitivity of 93.8% as it diagnosed 61/65 cases. Conclusion: Fibre-optic bronchoscopy - along with its guided procedures - is easy, minimally invasive and is associated with few risks. We recommend that all clinico-radiologically suspected cases of lung cancers should be investigated by BAL, brushings, and endobronchial biopsy wherever possible, since using one or two of the procedures decreases the diagnostic yield of FOB. © 2018, Indian Academy of Clinical Medicine. All rights reserved.