Bronchoscopy and fine needle aspiration cytology aided diagnosis of suspected lung malignancy- A prospective observational study

Abstract

Background: Flexible bronchoscopy is the main modality of diagnosing lung malignancy as per the location of lesion in our setup. Accurate diagnosis and categorization into various types is vital for its prognostic and management point of view.

Objectives: The study was conducted to find out yield of bronchoscopy and FNAC in suspected lung lesion and to know the various subtypes of bronchogenic carcinoma.

Methodology: The study was conducted in Kathmandu Medical College Teaching Hospital from December 2016 to May 2018. This was a prospective observational study conducted in 90 radiological suspected lung lesions. Radiological, bronchoscopy, histopathological and cytopathological findings were analyzed and evaluated. Data were recorded on a pre-designed proforma and entered into Statistical Package for the Social Sciences version 20.

Results: Among 90 suspected lung lesions who underwent contrast enhanced computed tomography, chest mass lesion was seen in 57(63.3%) subjects, nodular in 8 (8.9%), consolidation in 7 (7.8%), fibrosis in 7 (7.8%), collapse in 6 (6.7%) and pleural effusion in 3 (3. 3%).The most common malignancy was squamous cell carcinoma (53.48%). Lung malignancy was more common among endobronchial growth. The tendency of lesion to be malignant however tended to be significant at right upper lobe (p=0.02). When the suspected lesion was mass, the occurrence of malignancy was significantly higher (p<0.05).

Conclusion: The diagnostic yield increases with presence of right upper lesion with endobronchial growth. When the lung lesion presents as mass, the yield of having malignancy is also higher.