DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160290

Correlation of bronchial biopsy with bronchoalveolar lavage in lung malignancies

Nazia Bhat, Mir Junaid Nazeir, Humaira Bashir, Nusrat Bashir, Summiya Farooq, Kaneez Fatima, Khalil M. Baba

Abstract


Background: Lung cancer is currently the most frequently diagnosed major cancer in the world and the most common cause of cancer mortality worldwide. It comprises about 17% of the total new cancer cases in males and 23% of the total cancer deaths. The objectives of this study were to compare bronchial biopsy and bronchoalveolar lavage (BAL) cytology and in the diagnosis of carcinoma lung. Study design was comparative study.

Methods: The study was done in the Department of Pathology, Sher-i-Kashmir Institute of Medical Science (SKIMS), Srinagar, Kashmir. All patients clinically/radiologically suspected of lung malignancies who presented between April 2004 and May 2012 and underwent both bronchial biopsy and BAL were included in the study.

Results: Out of a total of 902 clinically suspected cases of lung cancer tumor was found in 760 cases (84.25%) by biopsy   and in 301 cases (33.37%) by BAL. The total number of false positive cases was 31 and false negative cases were 490.Sensitivity of BAL was found to be 35.5% and specificity 78.16%.

Conclusions: In the present study yield of diagnosis was highest with the bronchoscopic biopsies and in maximum number of cases, specific histologic diagnosis was made by biopsies only. Though BAL was inferior to bronchial biopsy in diagnosing lung malignancies but it was effective for peripheral lung malignancies and when the patient was at risk of hemorrhage.

 


Keywords


Bronchoalveolar lavage, Lung carcinoma, Biopsy, Sensitivity

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References


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.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90.

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.

Magrath I, Litvak J. Cancer in developing countries opportunity and challenge. J. Nat. Cancer, Itrt. 1993;85(ll):862-74.

Tanwani AK, Haque AU. Correlation of bronchial brushing with biopsy in lung lesions. Pakistan J Med Res. 2000;39(3):115-20.

Rivera MP, Detterbeck F, Mehta AC. American College of Chest Physicians. Diagnosis of lung cancer: the guidelines. Chest. 2003;123:129S-36S.

Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003;(123):115S-28S.

Rennard SI. Bronchoalveolar lavage in the diagnosis of cancer. Lung. 1990;168:1035-40.

Lachman MF, Schofield K, Cellura K. Bronchoscopic diagnosis of malignancy in the lower airway: A cytologic review. Acta Cytol. 1995;39:1148-51.

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.

Kotadia TP, Jasani JH, Vekaria PN. Comparison of bronchial biopsy, broncho alveolar lavage (BAL), brushcytology and imprint cytology in suspected cases of lung cancer International Journal of Biomedical And Advance Research. 2013:04(09):580-4.

Popovich J, Kvale PA, Eichenhorn MS, Radke JR, Ohorodnik JM. Diagnostic accuracy of multiple biopsies from flexible fiberoptic bronchoscopy. A comparison of central versus peripheral carcinoma. Am Rev Respir Dis. 1982;125(5):521-3.

Naryshkin S, Daniels J, Young NA. Diagnostic correlation of fiberoptic bronchoscopic biopsy and bronchoscopic cytology performed simultaneously. Diagn Cytopatho. 1992;8:119-23.

Govert JA, Dodd LG, Kussin PS, Samuelson WM. A prospective comparison of fiberoptic transbronchial needle aspiration and bronchial biopsy for bronchoscopically visible lung carcinoma. Cancer. 1999;(87):121-34.

Lam WK, So SY, Hsu C, Yu DY. Fibreoptic bronchoscopy in the diagnosis of bronchial cancer: comparison of washings, brushings and biopsies in central and peripheral tumours. Clin Onco. 1983;(9):35-4.

Linder J, Radio SJ, Robbins RA, Ghafouri M, Rennard SI. Bronchoalveolar lavage in cytologic diagnosis of carcinoma of the lung. Acta Cytol. 1987;31:796-801.

De Gracia J. Bravo C, Miravitlles M, Tallada N, Orriols R, Bellmunt J. Diagnostic value of bronchoalveolar lavage in peripheral lung cancer. Am Rev Respir Dis. 1993;147(3):649-52.

Debeljak A, Mermolja M, Sorli J, Zupancic M, Zorman M, Remskar J. Bronchoalveolar lavage in the diagnosis of peripheral primary and secondary malignant lung tumors. Respiration. 1994;61:226-30.

Rennard SI. Bronchoalveolar lavage in the assessment of primary and metastatic lung cancer. Respiration. 1992;59(1):41-3.

Robert P. Baaghman. Bronchoscopy, lung biopsy and other diagnostic procedures In. Murray. Nadel Mason. Boushey Textbook of Respiratory Medicine. 3rd ed. United States of America. W.B. Saunders Company. 2000;725-8.

Khan NA, Afroz F, Lone MM, Teli MM, Muzaffar M, Jan N. Profile of Lung Cancer in Kashmir, India: A Five-Year Study. The Indian Journal of Chest Dis and Allied Sci. 2006;48:187-90.

Fuladi AB, Munje RP, Tayade BO. Value of Washings, Brushings, and Biopsy at Fibreoptic Bronchoscopy in the Diagnosis of Lung Caner. JIACM. 2004;5(2):137-42.

Rajeskaran S, Manickam TG, Visanthan PJ, Jayachandran CS, Subbaraman R, Bhanumathy V, et al. Pattern of primary lung cancer: A Madras study. Lung India. 1993;11(1,2):7-11.

Gupta D, Boffeta P, Jindal GV, Vaccarella SK, Herrero S, Nandakumar R, A Risk factors of lung cancer in Chandigarh, India. Ind J Med Res. 2001;113:142-50.

Sheikh S, Shah A, Arshed A, Makhdoomi R, Ahmad R. Histological Pattern of Primary Malignant Lung Tumours Diagnosed in a Tertiary Care Hospital: 10 Year Study Asian Pacific J Cancer Prev. 2010;11:1341-6.

Travis WD, Travis L, Devesa SS. Lung Cancer. 1995;75:191-202.

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.

Pirozynski M. Bronchoalveolar lavage in the diagnosis of peripheral primary lung cancer. Chest 1992;102(2):372-4.

Wongsurakiat P, Wongbunnate S, Dejsomritrutai W, Charoenratanakul S, Tscheikuna J, Youngchaiyud P, et al. Diagnostic value of bronchoalveolar lavage and post bronchoscopic sputum cytology in peripheral lung cancer. Respirology. 1998;3(2):131-7.

Gaur DS, Thapliyal NC, Kishore S, Pathak VP. Efficacy of broncho-alveolar lavage and bronchial brush cytology in diagnosing lung cancers. J Cytol. 2007;24:73-7.

De Gracia J. Bravo C, Miravitlles M, Tallada N, Orriols R, Bellmunt J. Diagnostic value of bronchoalveolar lavage in peripheral lung cancer. Am Rev Respir Dis. 1993;147(3):649-52.

Tuladhar A, Panth R, Joshi AR. Comparative analyses of cytohistologic techniques in diagnoses of lung lesions. Journal of Pathology of Nepal. 2011;1:126 -30.

Ng AB, Horak GC. Factors significant in the diagnostic accuracy of lung cytology in bronchial washing and sputum samples. I. Bronchial washings. Acta Cytol. 1983;27(4):391-6.

Underwood RD, Greenberg SD, McLarty JW. Diagnosis and typing of lung carcinomas by cytopathologic methods. A review of 108 cases. Acta Cytol. 1985;29(3):379-84.