Value of bronchial wash and brush cytology in addition to histology in the diagnosis of lung cancer

A retrospective study was performed to evaluate the diagnostic yield of lung cancer on biopsy, bronchial washings and brushings taken at fibreoptic bronchoscopy. Records of 526 patients were analysed and eventually 107 patients with endobronchial lesions, who had had biopsy, washing and brushing were included in this study. 89 cases were found to be malignant. Squamous cell carcinoma was the most common malignancy. Brush was found to be better than wash in tumor typing, though overall tumor typing using cytology was poor. Sensitivities of bronchial wash, bronchial brush and biopsy were found to be 70.8%, 64% and 94.4% respectively. Biopsy gave the only positive result in 38.2%, only brush in 1.1% and only wash in 1.1% malignant cases. Diagnostic accuracy of bronchial biopsy, brush and wash was found to be 95.3%, 70% and 73.8% respectively. Addition of bronchial wash and brush increased the positive yield by only 2.2% which was insignificant. It was concluded that the wash and brush cytology do not significantly add to the overall yield of positive results obtained from biopsies in endobronchial lesions. Keywords: Lung cancer, Fibreoptic bronchoscopy, Bronchial wash cytology, Bronchial brush, Endobronchial biopsy, Diagnostic accuracy.