A Study on Accuracy of Respiratory Cytology for Cancer Diagnosis

Sputum cytology has been the traditional focus for teaching respiratory cytology for many years. However emphasis has been altered by the introduction of Fibreoptic brochoscopy and Fine needle aspiration. Bronchial brushings, washings, fine needle aspiration and lavage procedures usually yield better diagnostic material than that is obtained by simple exfoliative sampling. The combined use of cytology and biopsy facilitates accurate classification of tumour type and enhances sensitivity of diagnosis of malignant tumours. Aim To evaluate our Institutional experience with bronchial washings, brush cytology and biopsy as diagnostic tools to enhance the sensitivity of malignant tumours. Methodology Bronchial washings, brushings and biopsy were obtained by using Fibreoptic bronchoscope from 40 patients. The cytology samples were received as unstained smears. The slides were stained with standard H& E stains. The biopsy specimens were fixed in neutral buffered formaldehyde, processed to paraffin blocks and also stained with H& E stains. Observation and Results Among the 40 cases studied, 17 were Squamous cell carcinoma, 3 were small cell carcinoma, 2 were adenocarcinoma.22 were diagnosed to be positive for malignancy by cytology as well as biopsy. Conclusion The accuracy of bronchial cytology is high enough to warrant its use in combination with bronchial biopsy in the diagnosis of lung cancer. Our study shows that a combination of three diagnostic modalities - bronchial washings, brushings and biopsy is the best strategy in the diagnosis of bronchoscopically visible lung cancer.