Correlation of Bronchoscopic Findings with the Clinicoradiological Profile of the Patients undergoing Fibreoptic Bronchoscopy in Cases of Lung Cancer

Abstract

Introduction: Lung cancer may manifest in various ways. It may have typical symptoms such as weight loss, cough, heamoptysis and can be confused with pneumonia or it may manifest as a part of paraneoplastic syndrome. Occasionally it may be detected incidentally during evaluation for other medical illness. The early detection rate of lung cancer is rising due to cancer screening programmes, improvement in resolution of Computerised tomography scanners and also refinements in bronchosocpy techniques such as endobrochial ultrasound and electromagnetic navigation, fluoroscopy guidance and virtual bronchoscopy. The aim of this study was to correlate bronchoscopic findings with clinicoradiological profile of patients with suspected lung cancer visiting our Tertiary Health Centre, Nashik. Materials and Methods: This was a prospective study, conducted in a tertiary care medical college hospital over a period of 2 years. Patients were recruited from department of pulmonary medicine and referred cases from other departments were also included. Results: Complete data records from 52 patients were available for statistical analysis. Maximum numbers of patients were in age group 41-60. All bronchoscopies were done under local anesthesia and short conscious sedation. Majority of bronchoscopies were done in males. There were no fatal complications. Biopsy of visible growth was the most useful diagnostic tool followed by bronchoalveolar fluid. Squamous cell carcinoma was the most frequent diagnosis. Conclusion: Bronchoscopy is an excellent tool to evaluate lung carcinoma and multimodality approach is always helpful. Experience of bronchoscopist is crucial and accuracy of procedure increase with experience. Incidence of adenocarcinoma is increasing in India but squamous cell carcinoma remains most frequent lung cancer. Transbronchial lung biopsy, Transbronchial needle aspiration and brush biopsy, brochoalveolar fluid aspiration are helpful tools. However the yield can be enhanced by using Endo bronchial ultrasound (ebus), fluoroscopic guidance and electromagnetic navigation, virtual brochoscopy. There is good correlation between clinicoradiological and bronchoscpoic diagnosis and early diagnosis of lung malignancy will help improve survival and quality of life of patients.