Bronchial brushing are still usefull in the diagnosis of peripheral lesions

Introduction: Flexible bronchoscopy is routinely used for pulmonary diagnosis, especially for central lesions. For peripheral pulmonary lesions (PPLs) the sensitivity of bronchoscopy varies from 16–87% because of different guiding, lesion characteristics and physician skill (1). Considering its low sensitivity (as low as 16%) brush sampling is not routinely performed for PPLs. Aim of these retrospective stydy was to evalute feasibility and utility of brushing as a tool in diagnostic approch of PPLs. Methods and Results: We retrospectively reviewed medical records of all consecutive patients with PPLs, who underwent bronchoscopy at SOC Pulmonology and Bronchial Endoscopy from January 2017 to December 2018. Blinded brushing was performed in 110/1891 (5,81%) (M/F 50/60, age (69,9 +/-10.6). All patients presented bronchus sign. Brushing was positive in 57/110 (51.81%) patients and it turned out to be the only positive sample in 33/57 (57,89%). In 53/110 (48,18%) was negative. Brushing was positive in lesions located: 8 in inferior left lobe, 10 in upper left lobe, 19 in upper right lobe, 9 in inferior right lobe and 11 in medium lobe. Cytologic diagnosis by brushing was indicative in 31/57 patients (54,38%) of adenocarcinoma, in 14/57 (24,56%) of squamous cell carcinoma and in 9/57 (15,78%) of small cell lung carcinoma. In 1/57 (1,75%) brushing was positive for melanoma. In 2/57 (3,50 %) was positive for metastasis. None of patients experienced pneumothorax or severe bleeding. Conclusion: To date, advanced guided bronchoscopy techniques should be associated to increased diagnostic yield in PPLs, but brushng sample should be regarded as a safe, qick and cost-effective tool and it should be still performed.