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IJCRR. 2014; 6(5): 43-47


COMPARISON OF BRONCHOALVEOLAR LAVAGE CYTOLOGY AND BIOPSY IN LUNG MALIGNANCY

Richa Sharma, Hemina Desai, Pankaj Malukani, R.N.Gonsai, H.M.Goswami.

Abstract
Background : Respiratory tract cytology is well established throughout the world as a vital diagnostic procedure in the evaluation of any patient with suspected lung malignancy and with the introduction of Flexible Fiberoptic Bronchoscopy, Bronchoalveolar Lavage is a popularly accepted tool for diagnosing lung cancer.
Aims and Objestives : 1) To determine the efficacy of BAL cytological technique in diagnosing carcinoma of lung and correlating them with histopathological diagnosis by Bronchial Biopsy 2) To study the variation in the results with regards to different morphological types of lung malignancies.
Material And Methods : A retrospective study was conducted at our tertiary care hospital. We selected 100 cases where bonchoalveolar lavage cytology samples as well as Bronchial Biopsy were taken. Samples were processed and reported as per the standard methods. Histopathological diagnosis by Bronchial Biopsy was considered as the “Gold Standard.” The samples were obtained by Flexible Fiber-optic Bronchoscopy done by the clinician.
Result : Sensitivity of BAL was 42% and Specificity was 89.6%. Positive Predictive Value (86%) and Negative Predictive Value (48%), False Negative Index (60%) and False Positive Index (11%) were also calculated. Accuracy was 59%. Morphologically,44% were classified as poorly differentiated carcinoma, 28% were adenocarcinoma, 16% were squamous cell carcinoma and 12% were small cell carcinoma on BAL cytology. While on Bronchial Biopsy 29% were poorly differentiated carcinomas, 21% were adenocarcinoma,15% were squamous cell carcinoma and 15% were small cell carcinoma.
Conclusion: Bronchoalveolar Lavage cytology is a good screening method for diagnosing lung malignancy as it is fairly sensitive and specific when compared with Bronchial Biopsy which is the “Gold Standard” method.

Key words: BAL (Bronchoalveolar Lavage), Bronchial Biopsy, Lung cancer



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