Title: Diagnostic Role of FOB in Radiological Hilar and Parahilar Shadow of Patients Reporting at Tertiary Care Centre
Authors: Dr Manish Gupta, Dr Archana Mittal, Dr V K Jain
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.63
Abstract
Fiberoptic bronchoscopy (FOB) is an important procedure for diagnosis of different respiratory problems. The present study was conducted to evaluate the diagnostic role of FOB in Hilar & Parahilar shadows and also to evaluate the value of bronchial Aspirate, brushing and biopsy in final diagnosis of various lung diseases. Study was carried out on 51 patients reporting the tertiary care centre of department. of T.B. and respiratory diseases, S.P. medical college, Bikaner, Rajasthan. Among the cases included in this study, 57% cases have both (Hilar & Parahilar) shadows at left side. Vocal cord paralysis was in 1/5th (20%) cases. Endobronchial growth found in 59% cases. External compression was observed in 21.5% cases followed by inflammation in 15.6% and normal in 9.8% cases. Definite diagnostic yield of FOB for various lung diseases was 86%. Maximum cases (72%) diagnosed as lung cancer. Max. diagnostic yield in diagnosing lung cancer was through bronchial brushing (70%). Maximum diagnostic yield of procedure for malignancy was in bronchial biopsy (88%). Thus FOB technique has a high diagnostic yield in current clinical practice. Results suggested that the diagnostic yield of FOB of present study is as good as with studies performed by other centres within the country and abroad. This technique is more constructive in diagnosis when combined with a sound clinical judgment and other supportive investigations.
Keywords: Fiberoptic bronchoscopy, Radiological, Hilar shadow, parahilar shadow, Diagnostic yield, lung cancer.
References
- Kdvenat DM, Rath GS, Anderson WM, Snider GL. Maximal extent of visualization of bronchial tree by flexible fibreoptic bronchoscopy. Am Rev Repair Dis 1984; 110: 88-90.
- Suratt PM, Smiddu JF, Gruber B, Deaths and complications associated with fibreioptic bronchoscopy. Chest 1976; 69: 747- 751.
- Cordasco EM, Jr, Mehta AC, Ahmad M. Bronchoscopical Induced bleeding: A summary of 9 years Cleveland clinic experience and review of literature. 1991;100:1141–7.
- Fein AM, Feinsilver SH. The approach to non resolving pneumonia in the elderly. Semin Respir Infect.1993;8:59–72.
- Foos L, Patuto N, Chhajed P, Tamm M. Diagnostic yield of flexible bronchoscopy in current clinical practice. Swiss Med Wkly 2001; 136: 155-159.
- Reichenberger F, Weber J, Tamm M, Bolliger CT, Dalquen P, Perruchoud AP, et al. The value of transbronchial needle aspiration in the diagnosis of peripheral pulmonary lesions. Chest 1999; 116: 704-708.
- Anandan PT, Rajagopal TP, James PT, Ravindran C. Clinical profile of patients undergoing fibreoptic bronchoscopy in a tertiary care setting. Indian J Bronchology 2006; 1:58-71.
- Wong PC, Lee J, Lam FM et al. Bronchoscopy in the diagnosis of lung cancer. Monaldi Arch Chest Dis 1999; 54: 394-398.
- Bhatia RS, Sibia SS. Practical applications - therapeutic uses of flexible fibreoptic bronchoscope. Lung India 1994; 12: 138-139.
- Barnet CR. Flexible fibreoptic bronchoscopy in critically ill patients - methodology and indications. Chest 1978; 73 (suppl) 746-749.