Comparison of bronchial biopsy, broncho alveolar lavage (BAL), brush cytology and imprint cytology in suspected cases of lung cancer

Abstract

Background: The use of cytological methods in the diagnosis of malignant lesions of the respiratory tract has been generally acclaimed as one of its most successful applications. Flexible fiberoptic bronchoscopy revolutionized respiratory cytology, as bronchial brushings, broncho-alveolar lavage and bronchial forceps biopsy became more easy, accessible and popular, shifting the emphasis from diagnosis of advanced malignancy in inoperable patients to the use of cytology as a first line diagnostic and management tool. Respiratory tract cytology is well established throughout the world as a diagnostic procedure in the evaluation of patient with suspected lung malignancy. Methodology: The present study compromises of bronchoscopic cytology and histology of bronchial biopsy in 80 patients suspected of lung tumors. The study was carried out in the department of pathology M.P. shah medical college and the samples of the bronchoscopic material were received from tuberculosis and chest department of G.G hospital Jamnagar. Results: Out of 80 patients 66 were found to be malignant. Some of the suspicious lesions turned out to be malignant in biopsy. In the carcinoma of lung squamous cell carcinoma was the most common carcinoma (39.39% ) followed by adenocarcinoma (21.21%) small cell carcinoma 13.63% and large cell carcinoma 7.57 %, majority of the cases 77.5 % were male predominat. Conclusion: Pulmonary cytology is an important, basic diagnostic tool for the detection of lung cancer, that too in early diagnosis. Fibroptic bronchoscopy is an easy, OPD procedure which is minimally invasive and without any risk. It provides direct visualization of respiratory tract as well as lesion proper and variety of specimens can be collected.