Parallelism in the Diagnostic Performance of Bronchoscopic Sampling Techniques in Lung Carcinoma

Context: Flexible bronchoscopy is the recommended procedure for diagnosis of all suspected lung carcinoma, having sensitivity of 88% for central airway lesion and 78% for peripheral. The diagnostic yield of bronchoscopy combining various sampling techniques for visible lesions was predicted to be at least 80%. Aims: To compare the diagnostic yield of various sampling techniques of bronchoscopy in diagnosing lung carcinoma at a rural tertiary care centre. Settings and Design: Retrospective observational study centre in respiratory medicine at tertiary care. Methods and Material: 26 bronchoscopies done in radiologically suspected malignancy in previous two and a half years were included. Histopathological or cytological evidence of malignant cells was considered as final diagnosis of malignancy. Data of radiological and bronchoscopic findings and reports of sampling techniques were analysed. Statistical analysis used: SPSS for windows. Results: The overall diagnostic yield is 46.15%, while for central lesion it is higher than peripheral lesion, 42.30 % and 7.69% respectively. EBLB gave highest diagnostic yield 69.2%. BAL cytology is the most common procedure performed. Central lesion on imaging and visible endobronchial abnormalities like narrowing, intraluminal growth, mucosal irregularity are predictors of higher diagnostic yield. Conclusions: The overall diagnostic yield in radiologically suspected lesions to be 46.15% and highest diagnostic yield with endobronchial lung biopsy. Central lesion on radiology and endobronchial abnormalities are strong predictors of high diagnostic yield, with highest yield in biopsy amongst all techniques. Hence biopsy should be done in all such cases.