The use of fiberoptic bronchoscopy and brush biopsy in the diagnosis of suspected pulmonary malignancy.

Abstract

Two hundred patients with radiographic or clinical evidence suggestive of pulmonary malignancy were examined with a 5 mm-fiberoptic bronchoscope. Biopsies with a nylon brush, passed through the channel of the instrument, were performed on 163 patients; the rest had bronchial washings submitted for cytologic examination. Of 130 patients proved to have primary carcinoma of the lung, cytologic material diagnostic of malignancy was obtained from IlO (85 per cent) by brush biopsy. Diagnostic cytology was obtained by direct brushing of 92 per cent of patients with endoscopically visible tumors and 78 per cent of peripheral carcinomas brushed under fluoroscopic control. The fiberoptic bronchoscope allows direct examination of the entire tracheobronchial tree to the sub segmental bronchi, and brush biopsy under fluoroscopic control can be performed even beyond this range. The examination can be quickly and easily performed with minimal risk or discomfort to the patient and provides highly accurate diagnostic information.