Abstract
Over the last two years from Nov 2015- Oct 2017 in the Dept. of Respiratory Medicine at Chandulal Chandrakar Memorial Medical College examine 43 patients with unexplained hemoptysis with normal chest roentgenograms underwent diagnostic fiberoptic branchoscopy (FBO). Ten patients were females with a mean age of 43.02 yrs. Normal findings were found in 26 patients and abnormal findings were observed in 17 patients with branchoscopy. Final diagnosis of malignancy in 3 patients, tuberculosis in 6 patients and pulmonary microfilariasis in 1 patient were found. All 3 malignancies were variety of squamous cell carcinoma. Above 3 patients were smokers and above 40 years of age. One of the carcinoma case was female passive smoker. However in any patients with persistent cryptogenic hemoptysis or who has no history of bronchitis elderly with high smoking index. FBO should be performed.
The interesting aspect of our study is an elderly female passive smoker was suffering from squamous cell carcinoma. Furthermore microfilaria was detected in bronchial washing of an young male patients, whose peripheral blood smear study was normal. All tuberculosis cases were above 40 years of age. On follow up one patient developed tubercular pleural effusion right-side. Hence on the basis of our result and findings we concluded that the FOB as a diagnostic aid for cryptogenic hemoptysis is useful.
Keywords: FBO, branchoscopy, hemoptysis, microfilariasis
References
- Marini J. Hemoptysis – Medicine for house officer 2nd edition Baltimore Williamson and Wilkins 1987.
- Stroller JK. Diagnosis and management of massive hemoptysis. A review respiratory care. 1992:32:564-81.
- Shamji PM, Wallieres E. Todder ER. Et. al. Massive life threatening hemoptysis. Chest; 1991:100;785.
- O Nail KM, Lazarus AA. Hemoptysis indication for bronchoscopy. Int. Med. 1991-Jan 151(1):171-4.
- https://www.ncbi.nlm.nih.gov/books/NBK360.
- Snider GL. When not use the broncho-scope for hemoptysis. Chest 1979;76;1-2.
- Peter J. Macclung H. Teague R. Evolution of hemoptysis in patients with normal chest roentgenogram. Westt J Medicine 1984. 141;624-6.
- Zavela D. Diagnostic fiberoptic bronchoscopy techniques and results of biopsy in 600 patients. Chest1975;68;12-19.
- Richardson RH. ZavelaDC. Mukharjee PK. Et.al. The use of fiberoptic broncho-scopy and brush biopsy in the diagnosis of suspected pulmonary malignancy. Am.Rev. Resp. Dis. 1974;109;63-66.
- Gong H. Saluatierra C. Clinical efficacy up early and delayed fiberoptic bronchoscopy in patients with hemoptysis. Am.Rev. Resp. Dis. 1981;124;221-225.
- Heimer D. Barr Ziv J. et.al. Fiberoptic bronchoscopy in patients with hemoptysis and nonlocalising chest roentgenogram. Arch. Int. Med. 1985;145;1427-28.
- Adelman M. Haponic EF. Bleecker ER. et.al. Cryptogenic hemoptysis clinical features Bronchoscopic findings and natural history in 67 patients. Ann. Int. Med. 1985;102; 829-834.
- Rath GS. Schaff JT. Flexible fiberoptic bronchoscopy. Chest 1973;63;689-93.
- JC Suri. A Goel and R. Singla. Cryptogenic hemoptysis: Role of fiberoptic bronchoscopy. Int. J.Chest Dis & All scizvol 1990;32;149-52.
- Lehrman S. Williams AJ. Bronchoscopy in patients with haemo-ptysis and normal chest roentgenogrm. Br.J.Dis.Chest 1987;81;186-87.
- Poe RH. Martin MG. Israel RH. et.al. Utilizing of fiber optic bronchoscopy in patients with hemoptysis and non localizing chest roentgenogrm. Chest. 1988;92;72-75.
- Schneider L: Bronchogenic carcinoma heralded by hemoptysis and ignored because of negative chest x-ray results. NY State J Med 1981; 59:556-559.
- Cole FH, Cole FH Jr: Selection of patients with hemoptysis for fiberoptic bronchoscopy (Letter). Chest 1980 May; 77:710.
- Gong, H. and Salvatierra, C. Clinical efficacy of early and delayed fiberoptic bronchoscopy in patients with hemoptysis. Am Rev Respir Dis. 1981; 124: 221–225.
- Richardson, R.H., Zavala, D.C., Mukerjee, F.K., and Bedell, G.N. The use of fiberoptic bronchoscopy and brush biopsy in the diagnosis of suspected pulmonary malignancy. Am Rev Respir Dis. 1974; 109: 63–66.
Corresponding Author
Dr Karan Singh Chandrakar
Assistant Professor Dept. of Pathology,
CCM Medical College Kachandur, Durg (CG)