Role of Bronchial Brush Cytology in Diagnosis of Central Bronchial Carcinoma

Background : Despite the advances in imaging techniques and treatment modalities, the prognosis of lung cancer remains poor, with five-year survival of 14% at early stages and less than 5% in locally advanced stages. Before starting treatment a clear distinction between small cell and nonsmall cell carcinoma must be made, for that histopathology remains the mainstay of confirmation of diagnosis. To combat the disease successfully, it should be diagnosed at earliest possible stage. If bronchial brush cytology yield comparable diagnostic specificity, then it may easy for the patient and physician to manage this fatal disease. Purpose : The study was designed to evaluate the diagnostic yield of bronchial brush cytology in central (endoscopically visible) bronchial carcinoma Subjects and methods: This cross sectional study was done in the Department of Medicine, and Respiratory Medicine units of Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2012 to June 2014.Thirty seven patients with clinically suspected bronchial carcinoma were enrolled in this study fulfilling the inclusion and exclusion criteria. In all cases bronchial brush cytology and endo-bronchial biopsy were performed and results of both techniques were compared Reasults: The mean age of the patients with bronchial carcinoma was 59.65 (SD 12.95) years; 28 (75.7%) patients were 51 years or above with a ratio of male to female of 17.5:1. The sensitivity of bronchial brush cytology in the diagnosis of central bronchial carcinoma was 89.2% and that of endobronchial biopsy was 67.6%, no true negative cases were detected. Five (13.5%) patients developed respiratory distress and minor bleeding in 4 (10.8%) as a complications of bronchoscopy procedure. Conclusion: The diagnostic yield of bronchial brush cytology is non inferior to than that of endobronchial biopsy in the diagnosis of central bronchial carcinoma. J Bangladesh Coll Phys Surg 2017; 35(2): 68-74