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2016 ; 33
(6
): 635-641
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Lung malignancy: Diagnostic accuracies of bronchoalveolar lavage, bronchial
brushing, and fine needle aspiration cytology
#MMPMID27890992
Sareen R
; Pandey CL
Lung India
2016[Nov]; 33
(6
): 635-641
PMID27890992
show ga
BACKGROUND: Early diagnosis of lung cancer plays a pivotal role in reducing lung
cancer death rate. Cytological techniques are safer, economical and provide quick
results. Bronchoscopic washing, brushing and fine needle aspirations not only
complement tissue biopsies in the diagnosis of lung cancer but also comparable.
OBJECTIVES: (1) To find out diagnostic yields of bronchioalveolar lavage,
bronchial brushings, FNAC in diagnosis of lung malignancy. (2) To compare
relative accuracy of these three cytological techniques. (3) To correlate the
cytologic diagnosis with clinical, bronchoscopic and CT findings. (4) Cytological
and histopathological correlation of lung lesions. METHODS: All the patients who
came with clinical or radiological suspicion of lung malignancy in two and a half
year period were included in study. Bronchoalveolar lavage was the most common
type of cytological specimen (82.36%), followed by CT guided FNAC (9.45%) and
bronchial brushings (8.19%). Sensitivity, specificity, positive and negative
predictive value for all techniques and correlation with histopathology was done
using standard formulas. RESULTS: The most sensitive technique was CT FNAC -
(87.25%) followed by brushings (77.78%) and BAL (72.69%). CT FNAC had highest
diagnostic yield (90.38%), followed by brushings (86.67%) and BAL (83.67%).
Specificity and positive predictive value were 100 % each of all techniques.
Lowest false negatives were obtained in CT FNAC (12.5%) and highest in BAL
(27.3%). Highest negative predictive value was of BAL 76.95 % followed by BB
75.59% and CT FNAC 70.59%. CONCLUSION: Before administering antitubercular
treatment every effort should be made to rule out malignancy. CT FNAC had highest
diagnostic yield among three cytological techniques. BAL is an important tool in
screening central as well as in accessible lesions. It can be used at places
where CT guided FNAC is not available or could not be done due to technical or
financial limitations.