Abstract
Background: The flexible bronchoscope has proved to be a versatile instrument with many clinical implications. Since its introduction 52 years ago; it has completely changed the perspective of diagnosis and treatment of various conditions affecting lungs. A prospective study was carried out to know the efficacy of bronchoscopic biopsyin patients of pulmonary diseases andto assess the clinical, bronchoscopicand pathological correlation.
Setting: Department of Tuberculosis and Chest Diseases, S.N.Medical College, Agra
Methodology: Flexible fibreoptic bronchoscopy with bronchoscopic biopsy was performed under local anesthesia in patients of bronchopulmonary diseases and biopsy specimens were sent for histopathological examinations.
Results: Endobronchial abnormalities were visualized in nearly 47.7% case. Mostcommon finding was exophytic growth seen in 57.1% of cases studied. Out of 44 cases, 36.36% were diagnosed as carcinomas and 43.18 % as non neoplastic. Squamous cell carcinoma (50%) was most common neoplastic lesion followed by adenocarcinoma (37.5%) in neoplastic category.
Conclusion: Bronchialbiopsy is simple and safe procedure which can be performed in out patients and provides significantly higher diagnostic yield in bronchopulmonary diseases with negligible minor complications.
Keywords: Tubercular pleural effusion, Fibreoptic bronchoscopy, Endobronchial Biopsy.
References
- Ikeda S, Yanai N, Ishikawa S. Flexible bronchofiberscope. Keio J Med. 1968;17:1–16.
- Panchabhai TS, Mehta AC. Historical perspectives of bronchoscopy.Connecting the dots. Ann Am Thorac Soc. 2015 May;12(5):631-41
- Preyas J Vaidya, Joerg D Leuppi, and Prashant N Chhajed. The evolution of flexible bronchoscopy: From historical luxury to utter necessity!!Lung India.2015 May-Jun; 32(3): 208–210.
- Kaparianos A, Argyropoulou E, Sampsonas F, Zania A, Efremidis G, Tsiamita M, et al. Indications, results and complications of flexible fiberoptic bronchoscopy: A 5-year experience in a referral population in Greece. Eur Rev Med Pharmacol Sci. 2008;12:355–63.
- Alamoudi OS, Attar SM, Ghabrah TM, Kassimi MA.Bronchoscopy, indications, safety and complications. Saudi Med J. 2000;21:1043–7.
- Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, et al. British Thoracic Society Bronchoscopy Guideline Group. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: Accredited by NICE.Thorax. 2013;68(Suppl 1):i1–44.
- Chadha M, Kulshrestha M, and Biyani A.Anaesthesia for bronchoscopy Indian J Anaesth.2015 Sep; 59(9): 565–573.
- Yosri M. Akl, Raef H. Emam, Irene M. Sabry, Abdullah A. Ali.Clinico-patholo-gical profile of bronchogenic carcinoma cases presented to Chest Department, Cairo University in the last 10 years. Egyptian Journal of Chest Diseases and Tuberculosis (2013) 62, 705–712
- Rosell A, Monso E, Lores L, Vila X, Llatjos M, Ruiz J,MoreraJ.Cytology of bronchial biopsy rinse fluid to improve the diagnostic yield for lung cancer.European Respiratory Journal. 1998 Dec 1; 12(6):1415-8.
- Funahashi A,Browne TK, Houser WC, HranickaLJ.Diagnostic value of bronchial aspirate and postbronchoscopic sputum in fiberoptic bronchoscopy. Chest. 1979 Nov 30; 76(5):514-7
- Chechani V. Bronchoscopic diagnosis of solitary pulmonary nodules and lung masses in the absence of endobronchial abnormality.Chest. 1996 Mar;109(3):620-5.
- Patil S, Rujuta A. ‘Bronchoscopic Characterization of Lesions’: Significant impact on lung cancer diagnosis with use of Transbronchial needle aspiration (TBNA) in Comparison to conventional diagnostic techniques (CDTs). Clin Cancer Investig J 2017;6:239-46
- Upama et al., Sch. J. App. Med. Sci., Dec 2016; 4(12C):4344-4353
- Kumar V,Cotran RS, Robbins SL Lungs and upper respiratory tract. In. Basic pathology 6th W.B. Saunders Company 1999: p393-43.
- Ahmad M, Afzal S, Saeed W, Mubarik A, Saleem N, Khan SA, Rafi S. Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours.Journal-Pakistan Medical Association. 2004 Jan; 54(1):13-6
- Tuladhar A. Panth R, Technique in diagnosis of lung lesions Comparative analysis of cytohistologicalexamination. Journal of Pathology of Nepal 2011; 1: 126-130.
- Choudhury M, Singh S, Agarwal S. Efficacy of bronchial brush cytology and bronchial washings in diagnosis of non-neoplastic and neoplastic bronchopul-monary lesions.Turk Patoloji Derg. 2012 May 1; 28(2):142-6.
- Cordasco EM, MehtaAC, Ahmad M. Bronchoscopically induced bleeding: a summary of nine years' Cleveland Clinic experience and review of the literature.Chest, 1991- journal.chestnet.org
Corresponding Author
Dr Ajay Kumar Verma
Assistant Professor, Department of Pulmonary & Critical Care Medicine
King George Medical University, Lucknow, UP, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.118
