Comparative analysis of fibreoptic bronchoscope aided cytohistological techniques in diagnosis of benign and malignant lesions of lung

Authors

  • Shilpa Garg Department of Pathology, SHKM GMC Nalhar Nuh, Haryana, India
  • Sanjay Verma Department of Pathology, Pt BD Sharma PGIMS Rohtak, Haryana, India
  • Rajnish Kalra Department of Pathology, Pt BD Sharma PGIMS Rohtak, Haryana, India
  • Rajeev Sen Department of Pathology, Pt BD Sharma PGIMS Rohtak, Haryana, India
  • Puja Sharma Department of Pathology, SHKM GMC Nalhar Nuh, Haryana, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230579

Keywords:

Lung, BAL, TBNA, FB

Abstract

Background: Morbidity and mortality from chronic lung diseases are increasing worldwide. A combination of various cytological and histopathological techniques are required for the high diagnostic accuracy. This study aims to evaluate and compare diagnostic accuracy of fiberoptic bronchoscope aided cytohistological techniques such as BAL (bronchoalveolar lavage), TBNA (Transbronchoscopic needle aspiration) and FB (forceps biopsy) in diseases of lung.

Method: A prospective study conducted on 100 patients with symptoms and signs of various respiratory diseases who underwent fibreoptic bronchoscopy. Diagnostic accuracy of various samples alone and in combination were analysed.

Results: Sensitivity of BAL-24%, TBNA 64% and FB 66%. Addition of BAL to FB increased the sensitivity to 69%. Addition of BAL to TBNA increased the sensitivity to 70%. Sensitivity of cytological methods (FB and TBNA) 90%. Addition of both BAL and TBNA to FB increased overall senstivity to 93%. FB the most specific amongst the three techniques with specificity of 94% followed by TBNA (59.4%) and BAL (50%).

Conclusions: There are variable results regarding diagnostic yields and utilities of various fibre-optic bronchoscope aided cytohistological techniques but there combination adds the yields. Thus a combination of various cytohistological samples should be taken in a patient undergoing fiberoptic bronchoscopic examination to increase the diagnostic yield, to cut short the diagnostic time and early start of treatment.

References

Chakraborty AK. Epidemiology of tuberculosis: Current status in India. Ind J Med Res. 2004;120:248-76.

Bilillo KS, Murin S, Mathay RA. Epidemiology, ethology, and prevention of lung cancer. Chin chest med 2002;23:1-25.

Nandkumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: development of an atlas of cancer of India. Int J Cancer. 2005;116:740-54.

BeheraD, Balamurugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci. 2004;46:269-81.

Gupta A, Mehta AC. Transbronchial needle aspiration an underused diagnostics technique. Clin Chest Med. 1999;20:39-51

Braughman RP, Deens M. Role of BAL in interstitial lung disease. Clin Chest Med. 2001;22:331-41.

Reichenberger F, Weber J, Tamm M, Bolliger CT, Dalquen P, Perruchoud AP et al. Thevalue of transbronchial needle aspiration in the diagnosis of peripheral pulmonary lesions. Chest. 1999;116:704-8.

Chechani V. Bronchoscopic diagnosis of solitary pulmonary nodules and lung masses in the absence of endobronchial abnormality. Chest. 1996;109:620-5.

Garg S, Handa U, Mohan H, Janmeja A. Comparative analysis of various cytohistological techniques in diagnosis of lung diseases. Diagn Cytopathol. 2007;35:26-31.

Amorin A, Lombardia E, Lucena M, Fernandes G, Mangelhaus A. Lung cancer diagnosis: Comparison of post bronchoscopy sputum cytology, Bronchial washing, brushing and biopsy. Dev Post Pneumaol 2003;IX:44-5

Johnston WW, Bossen EH. Ten years of respiratory city pathology at Duke university Medical centre II. The cytopathologic diagnosis of lung cancer during the years 1970 to 1974, with a comparison between city pathology and histopathology in the typing of lung cancer. Acta cytol 1987;25:499-505.

Payne CR, Hadfield JW, Stovin PG, Barker V, Heard BE, Stark JE. Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma. Clin Pathol. 1981;34:773-8.

Jay SJ, Wehr K, Nicholson DP, Smith AL. Diagnostic senstivity and specificity of pulmonary cytology: Comparison of techniques used in conductor with flex fiberoptic bronchoscopy. Acta Cytol. 1980;24:304-12.

Schenk DA, Bryan CL, Bower JH, Myers DL. Transbronchial needle aspiration in the diagnosis of bronchial carcinoma. Clin Pathol. 1981;36:508-11.

Buirski G, Calverly P, Douglas NJ, Lamb D, Mcintyre M, Sudlow MF, White H. Bronchial needle aspiration in the diagnosis of bronchial carcinoma. Thorax. 1981;36:508-10.

Xing ZL. Evaluation of transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma. Zhonghua Jie He He Hu Xi Za Zhi. 1989;12:356-8

Govert JA, Dodd LG, Kussin PS, Samuelson WM. Aprospective comparisn of fibre optic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma. Cancer. 1999;87:129-34.

Karahalli E, Yilmaz A, Turker H, Ozvaran K. Usefullness of various diagnostic techniques during fibre optic bronchoscopy for endoscopically visible lung cancer: should city logic examinations be performed routinely? Respiration. 2001;68:611-4.

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Published

2023-02-28

How to Cite

Garg, S., Verma, S., Kalra, R., Sen, R., & Sharma, P. (2023). Comparative analysis of fibreoptic bronchoscope aided cytohistological techniques in diagnosis of benign and malignant lesions of lung. International Journal of Research in Medical Sciences, 11(3), 950–955. https://doi.org/10.18203/2320-6012.ijrms20230579

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Original Research Articles