ABSTRACT

To compare the diagnostic accuracy of bronchial cytology (trans-bronchial needle aspiration, bronchoalveolar lavage, and bronchial brushings) and bronchial biopsy in the diagnosis of lung carcinoma and to examine the factors that have an influence on accuracy.

Both bronchoscopic biopsies and bronchial cytologi-cal materials of 64 patients sent to Gazi University Medical Faculty Pathology Department, between April 2006 and February 2007 were studied. The findings of biopsy and cytology were compared with the diagnosis of resection materials or clinical follow-up data, and factors that influenced the results were exami-ned. Clinical and radiological data were collected from patients’ files.

Of the 64 patients, 35 had lung cancer and 29 had benign lung dise-ases. Twenty-eight of the 35 patients’ biopsy and/or cytological examinations revealed carcinoma, while seven of them were reported as benign. All of the 29 patients with benign lung disease had diagnoses of benign biopsies and cytologies. The sensitivity of bronchial biopsy and bronchial cytology alone was 65.71%, and 51.42%, respectively. If they were performed together the sensitivity increased to 84.3%. The sensitivity of TBNA, BAL, and bronchial brushings was 50%, 18.75%, and 56.25% respectively. If the size of the biopsy was 0.4 cm, the sensitivity was 50%, and the number of pieces biopsied was 3, the sensitivity was 83%.

The sensitivity of bronchoscopic biopsy and brushing cytology are highest for endobronchial lesions. For peripheral lesions brushing cytology has the highest sensitivity, and biopsy follows it. The possibility of a correct diagnosis is highest when the biopsy size is 0.4 cm and biopsied pieces number IS 3 or 4