Efficacy of bronchial cytology in diagnosing lung lesions and its correlation with bronchial biopsy

Abstract

Introduction: Neoplastic and non-neoplastic lung lesions have a high rate of morbidity and mortality. Lung cancer is the frequently diagnosed cause for cancer related deaths and tuberculosis is still the leading cause of death in developing countries. Timely detection of disease plays an important role in the management and long term survival of patients. For early diagnosis different diagnostic modalities are available which include bronchoalveolar lavage, bronchial brush, fine needle aspiration cytology and bronchial biopsy. Bronchoalveolar lavage and bronchial brush are very effective in the diagnosis and differential diagnosis of lung cancers. Bronchial brushings often offer excellent specimens and accurate information about the site of the lesion. Better diagnostic yield is often obtained when cytologic techniques are used together with bronchial biopsy. The present study was undertaken to ascertain the role and diagnostic utility of bronchoalveolar lavage, bronchial brush and bronchial biopsy in diagnosing lung lesions.

Method: A prospective study was conducted in the Department of Pathology in Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal from January 2016 to December 2017 (2 years). A total of 48 cases were included in the study. Bronchoalveolar lavage, bronchial brush and bronchial biopsy slides were stained with routine cytological and histological staining and examined.

Results: Out of 48 cases, bronchoalveolar lavage smears revealed 24 non-neoplastic, 19 neoplastic and 5 suspicious cases. Bronchial brush smears revealed 24 neoplastic, 22 non-neoplastic and 2 suspicious cases. Bronchoscopic biopsy revealed 31 neoplastic and 17 non-neoplastic lesions. The bronchial brush cytology showed sensitivity of 82.76%, specificity of 89.47% and accuracy of 85.42%.

Conclusion: Combination of bronchial cytology and biopsy can be considered as the best procedures for the diagnosis of lung lesions.