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Category: Volume 07 Issue 09 September 2019
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Title: Comparative Cytological Techniques in the Diagnosis of Non Neoplastic and Neoplastic Bronchopulmonary Lesions

Authors: Dr Meenakshi Gundewar, Dr Pragati Karmarkar, Dr Sadhana Mahore

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.72

Abstract

  

Objective: Diagnostic cytology is one of the suitable modality for both non-neoplastic and neoplastic conditions of the lung. The aim is to use different cytological methods in the diagnosis of lesions of the respiratory tract. It has been generally acclaimed as one of the most successful application in the evaluation of patient with suspected lung malignancy.

Materials and Method: It was a prospective study of 127 cases. The present study was conducted in the department of pathology at a tertiary care hospital. It is a cross- sectional study, carried out on all patients who were admitted with lung diseases during a period of two years .  Both male and female patients of all age group with the specified respiratory tract complaints like cough, breathlessness, hemoptysis, fever and chest pain were subjected to bronchoscopic examination.

Results: There were 81 males and 46 females. Male : female ratio was 1.76 : 1. The mean age was 50±16.14 years. The lowest age was 14 years and the oldest age was 85 years. It was included in both the non- neoplastic and neoplastic study groups. Sensitivity of BB was 91.8%; while that of BAL was only 59.2%. specificity of BB was 87.5% and that of BAL was 75%. Accuracy of BB was 90.7% while that of BAL was 63.1%.

Conclusions: Bronchial brushing is a much superior technique in the diagnosis of bronchopulmonary lesions. It demonstrates far better sensitivity, specificity and accuracy. Combination of various cytohistological techniques complements each other and enhances the diagnostic efficacy of various non- neoplastic and neoplastic lung diseases.

Keywords: cytology, lung, techniques.

References

  1. Choudhury M., Singh S., Agarwal S. Efficacy of Bronchial Brush Cytology and Bronchial Washings in Diagnosis of Non Neoplastic and Neoplastic Bronchopulmonary Lesions. Turk Patoloji Derg 2012, 28:142-146.
  2. Tuladhar A, Panth R, Joshi AR: Comparative analyses of cytohistologic techniques in diagnoses of lung lesions. Journal of Pathology of Nepal 2011, 1:126-130.
  3. Shiner RJ, Rosenman J, Katz I, Reichert N, Hershko E, Yellin A. Bronchoscopic evaluation of peripheral lung tumors. Thorax 1988;43:887-9.
  4. Wallace JM, Deutsch AL, Harrell JH, Moser KM: Bronchoscopy and transbronchial biopsy in evaluation of patients with suspected active tuberculosis. Am J Med 1981, 70:1189–1194
  5. Altaf Bachh A, Gupta R, Haq I, Varudkar HG:Diagnosing sputum /smear-negative pulmonary tuberculosis: Does fibreoptic bronchoscopy play a significant role? Lung India 2010, 27:58–62
  6. Purohit SD, Sisodia RS, Gupta PR, Sarkar SK, Sharma TN: Fibreoptic bronchoscopy in the diagnosis of smear negative pulmonary tuberculosis. Lung India 1983, 1:143–146
  7. Kulpati DD, Heera HS: Diagnosis of smear negative pulmonary tuberculosis by flexible fibreoptic Indian J Tuberc 1986, 33:179–182
  8. Andrews1985Andrews, L. Joseph Jr, Sarahbloom, Karohy Balogh (1985): Lung cancer in women, Lahey Clinic Experience, 1957-1980: Cancer 55 : 2894-2898.
  9. Duffie H. et al 1987Mc. Duffie H. Helen David J. Klaasen & James A. Dosman (1987): Female Male differences in patients with primary lung cancer 59 : 1825 - 1830.
  10. Reddy A.S., Vivekanand N., Durga K. Efficacy of bronchial wash and brush cytology in the diagnosis of lung cancers. Sch. J. App. Med. Sci.,, 2014; 2(2D):816-820.
  11. Malhotra V, Malik. R. Beohar P.C, Gondal R (1986): Tumors of the lung – A histomorphological study, Indian Journal of Chest Diseases and Allied Sciences 28: No. 1, 28 - 40.3.
  12. Faiza a. z. al-rawi msc. Ficpath. Bronchial wash in the diagnosis of lung lesions. Iraqi j med sci, 2004; vol. 3(2): 125-127
  13. Gaur DS, Thapiyal NC, Kishore S, Pathak VP: Efficacy of bronchial alveolar lavage and bronchial brush cytology in diagnosing lung cancers. J Cytol 2007, 24:73-77. (17)
  14. Arora VK, Seetharaman ML, Ramkumar S, Mamatha TV, Subbarao KSVK, Banerjee A et al.; Bronchogenic carcinoma, Clinicopathological pattern in South Indian Population. Lung India, 1990; 8(3): 133-136.
  15. Srividya. V.V.L, Dr.Sailendra.Vaddadi, Dr.Dost Mohmad khan. Correlative study of lung tumors by bronchial washings, brush biopsy & foreceps biopsy. Int J Biol Med Res. 2014; 5(1): 3817-3826.(56)
  16. Hensing T. A. Clinical evaluation and staging of patients who have Lung cancer. Hematol Oncol Clin N Am. 2005; 19:219-23.
  17. van der Drift MA, van der Wilt GJ, Thunnissen FB, Janssen A prospective study of the timing and cost-effectiveness  of bronchial washing during bronchoscopy for pulmonary malignant tumors. Chest 2005; 128 (1): 394- 400.
  18. Sarma A, Sharma JD, Bhuyan C, Kataki AC, Sangma RA; A study of cytological evaluation of bronchial washing and brushing in Bronchogenic Carcinoma. International Journal of Scientific and Research Publications, 2013; 3(8): 1-7.
  19. Tamboli P & Ro.J.Y: Pathologic evaluation of lung cancer. Lung Cancer. M.D. Anderson cancer cares series; M.D. Anderson cancer center, Texas, 2003.
  20. Ahmad M, Afzal S, Saeed W, Mubarik A, Saleem N, Khan SA, et al. Efficacy of bronchial wash cytology and its correlation with biopsy in lung tumours.J Pak Med Assoc. 2004;54 : 13–6.
  21. Di Bonito L, Colautti I, Patriarca S, et al. Cytological typing of primary lung cancer: study of 100 cases with autopsy confirmation. Diagn Cytopathol 1991;7:7-10. (28)
  22. Piaton E, Djelid D, Duvert B, Perrichon M, Saugier B. Sequential use of bronchial aspirates, biopsies and washings in the preoperative management of lung cancers. CytoJournal,2007 jun 4;4:11
  23. Truong LD, Underwood RD, Greenberg SD, McLarty JW. Diagnosis and typing of lung carcinomas by cytopathologic methods. A review of 108 cases. Acta Cytol 1985; 29:379-84. 
  24. Ng ABP, Horak GC. Factors significant in the diagnostic accuracy of lung cytology in bronchial washing and sputum samples: II. Sputum samples. Acta Cytol 1983; 27 : 397-402.(14)
  25. Naryshkin S, Daniels J, Young NA. Diagnostic correlation of fiberoptic bronchoscopic biopsy and bronchoscopic cytology performed simultaneously. Diagn Cytopathol 1992; 8:119-23.
  26. Chopra SK, Genvesi MG, Simmons DH, Gothe B. Fibreoptic bronchoscopy in the lung cancer. Comparison of pre and post bronchoscopic sputa, washings, brushings and biopsies. Acta Cytol 1977; 21(4) : pp 524 -527 (36)
  27. Pilotti, Rilke F, Gribaudi G, Ravasi GL. Sputum cytology for the diagnosis of carcinoma of the lung. Acta Cytol 1982; 26: 649-54. (122)
  28. Shroff CP. Abrasive bronchial brushing cytology. A preliminary study of 200 specimens for the diagnosis of neoplastic and non-neoplastic broncho- pulmonary lesions. Acta Cytol 1985; 29 : 101-7. (123)
  29. zavala DC. Diagnostic fiberoptic bronchoscopy: techniques and results of biopsy in 600 patients.1975;68:12–19. (38)
  30. Solomon DA, Solliday NH, Gracey DR. Cytology in fiberoptic bronchoscopy: comparison of bronchial brushing, washing and post-bronchoscopy sputum. Chest 1974; 65:616-9.

Corresponding Author

Dr Pragati Karmarkar

Department of Pathology, NKP Salve Institute of Medical Science and Research Centre, Nagpur, India