Efficacy of Bronchial Brush Cytology and Bronchial Washings in Diagnosis of Non Neoplastic and Neoplastic Bronchopulmonary Lesions

Monisha CHOUDHURY; Smita SINGH; Savita AGARWAL

doi:10.5146/tjpath.2012.01113

Objective: The present study is based on the cytologic evaluation of bronchial brushings for the diagnosis of non neoplastic and neoplastic bronchopulmonary lesions and relation of the cytologic findings with clinical diagnosis and histopathologic examination wherever possible.

Material and Method: 35 symptomatic patients were selected on whom bronchoscopy was done. Bronchial brushing was performed using straight brushes and bronchial washing specimens were collected after brushing samples. Smears were stained by Pap, H&E, and Giemsa in all the cases while PAS and Ziehl Neelsen stainings were done in selected cases. Endobronchial biopsy was performed using a flexible long biopsy forceps.

Results: The age of the patients varied from 18 to 88 years, and the male:female ratio was 3.3:1. Carcinoma was diagnosed in 21 (60%) out of total 35 cases on bronchial biopsy and the remaining 14 cases (40%) showed inflammatory, tuberculous or no significant pathology. Bronchial washing showed 10 true positive, 10 true negative, 4 false positive and 11 false negative cases whereas bronchial brushing showed 17 true positive, 12 true negative, 2 false positive and 4 false negative cases as confirmed on biopsy. Bronchial brushing showed good sensitivity (80.9%) and specificity (85.7%) compared to bronchial washing which had sensitivity of 47.6% and specificity of 71.4%.

Conclusion: These findings attempted to confirm the concept that pulmonary cytology has improved to the point that its sensitivity is high enough to justify its use as a definitive diagnostic tool in those cases in which tissue diagnosis is not possible.