SENSITIVITY OF BRONCHIAL BIOPSY VERSUS BRONCHIAL WASHINGS AND BRUSHINGS IN CASES OF COLLAPSE

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SENSITIVITY OF BRONCHIAL BIOPSY VERSUS BRONCHIAL WASHINGS AND BRUSHINGS IN CASES OF COLLAPSE

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 46

Abstract

BACKGROUND Collapse also known as atelectasis is defined as decrease in volume or a portion of lung. Collapse is not a disease, but an important sign that results from disease or abnormalities in the lung. The major causes of collapse of lung include lung cancer, endobronchial TB, endobronchial metastasis, infection, bronchiectasis, foreign body, mucous plugging etc. Therefore, it is necessary to use diagnostic tools such as fibreoptic bronchoscopy to get an accurate diagnosis of underlying cause in a patient presenting with collapse on chest radiograph or CT chest. In general, the concordance between cytology and histopathology ranges from 70% to 90% and the bronchial biopsy is confirmatory for most of the cytological findings. An attempt has been made to determine the sensitivity of bronchial biopsy vs. bronchial washings and brushings in cases of collapse. The current study was planned with an objective of assessing the correlation of cytology of bronchial brushing and washings with histopathology of bronchial biopsy. The present study is an institutional based prospective study conducted on 30 patients presenting with collapse of lung to evaluate sensitivity of bronchial washings and brushings with biopsy. MATERIALS AND METHODS In this observational, descriptive, cross-sectional study all patients referred (during study period) for pulmonary consultation for suspected lung collapse were considered for fibreoptic bronchoscopy and the appropriate samples were sent for washings, brushings and biopsy. RESULTS Out of 30 patients of collapse of lung, aetiological diagnosis was known by FOB in 29 patients (96.66%) and unknown in 1 patient (3.33%). The diagnostic rate of FOB is 96.66%. Malignancy is the most common cause of collapse in the present study, 17 patients had malignancy (56.66%) followed by tuberculosis in 10 patients (33.33%) and foreign body in 2 patients (6.66%). The aetiology could not be made out with bronchoscopy in 1 case (3.33%). The major cause of collapse in young patents (< 40 yrs.) is nonmalignant causes like tuberculosis (75%). The major cause of collapse in middle-aged and old-aged patients is malignancy (88.88%). Foreign body is the cause of collapse in two patients, both < 10 yrs. of age. In the present study, in all 30 patients, bronchial biopsy, brushings and bronchial washings were taken. In 29 patients (96.66%), aetiological diagnosis was made. Among the 17 patients diagnosed by FOB as malignancy 17 patients (100%) had positive result with bronchial biopsy, 14 patients had positive results with bronchial brushings (82.35%), whereas only 8 patients (47.05%) had positive result with bronchial washings. The yield with bronchoscopic biopsy is better than bronchial brushings and bronchoscopic washings in the diagnosis of malignancy presenting with collapse of lung. Among the 10 patients diagnosed by FOB as endobronchial tuberculosis all 10 patients (100%) had positive result with bronchial washings, 7 patients (70%) had positive result with bronchial brushings, 4 patients had positive results with bronchial biopsy. CONCLUSION The yield with bronchoscopic washings is better than brushings and biopsy in the diagnosis of endobronchial tuberculosis presenting with collapse of lung.

Authors and Affiliations

Pandu Viritha, Sri Teja, Venkata Ramana Reddy V

Keywords

EP ID EP548050
DOI 10.14260/jemds/2018/1114
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