Correlation of bronchial biopsy with bronchoalveolar lavage in lung malignancies

Background: Lung cancer is currently the most frequently diagnosed major cancer in the world and the most common cause of cancer mortality worldwide. It comprises about 17% of the total new cancer cases in males and 23% of the total cancer deaths. The objectives of this study were to compare bronchial biopsy and bronchoalveolar lavage (BAL) cytology and in the diagnosis of carcinoma lung. Study design was comparative study. Methods: The study was done in the Department of Pathology, Sher-i-Kashmir Institute of Medical Science (SKIMS), Srinagar, Kashmir. All patients clinically/radiologically suspected of lung malignancies who presented between April 2004 and May 2012 and underwent both bronchial biopsy and BAL were included in the study. Results: Out of a total of 902 clinically suspected cases of lung cancer tumor was found in 760 cases (84.25%) by biopsy   and in 301 cases (33.37%) by BAL. The total number of false positive cases was 31 and false negative cases were 490.Sensitivity of BAL was found to be 35.5% and specificity 78.16%. Conclusions: In the present study yield of diagnosis was highest with the bronchoscopic biopsies and in maximum number of cases, specific histologic diagnosis was made by biopsies only. Though BAL was inferior to bronchial biopsy in diagnosing lung malignancies but it was effective for peripheral lung malignancies and when the patient was at risk of hemorrhage.