Bronchial Brushing in Bronchogenic Carcinoma

Parker, Ralph L.; Haesaert, Susan P.; Kovnat, Daniel M.; Bachus, Bruce F.; Snider, Gordon L.

doi:10.1378/chest.71.3.341

Cited by 18 publications

(1 citation statement)

References 12 publications

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“…Lymphocytes, neutrophils and eosinophilic leukocytes accounted for the majority of other cells seen. Recent studies have suggested that serial lavages on consecutive days may result in increases in neutrophils and eosinophils in bronchial washings [18]. In our study, each lobe was lavaged 5 times to collect the cytologic specimen.…”

Section: Discussionmentioning

confidence: 99%

Bronchopulmonary Lavage Cytology in the Dog: Normal Findings

1980

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Abstract. Fiberoptic bronchoscopy was used to obtain cytologic specimens from all lung lobes of 9 normal Beagle dogs. Three specimen collection techniques (bronchial lavage, bronchial brushing and bronchial pinch biopsy imprints) and two staining procedures (WrightGiemsa and Papanicolaou) were used and evaluated. Bronchial lavage was the most satisfactory technique for collection of samples from the deep lung and bronchial brushings were preferred for potential bronchial tree mural lesions. Wright-Giernsa was the stain of choice because mast cells could not be identified and eosinophilic leukocytes could be identified only with difficulty in Papanicolaou stained specimens. Total and differential cell counts were determined on all bronchial lavages from all lung lobes in order to establish baseline reference values. Total nucleated cell counts ranged from 260-1200/JLl. There were no significant differences among mean total nucleated cell counts for the different lung lobes. Mean total nucleated cell counts were between 420 and 630 cells/st. Approximately 95% of all nucleated cells in normal lavages were undifferentiated alveolar macrophages. Most of the other cells seen were neutrophils, eosinophils, possible globule leukocytes and mast cells. Ciliated and nonciliated epithelial cells comprised less than I% of the total nucleated cell population.Cytologic evaluation of tracheobronchial secretions of man was first described in the mid-19th century [6]. The technique gained acceptance as a diagnostic procedure in 1887 when cytologic evaluation of sputum led to a diagnosis of pulmonary neoplasms several months prior to death [12]. Nevertheless, little progress was made until techniques for wet-fixation of respiratory tract secretions were perfected in the mid-1930's [9]. A comprehensive review of pulmonary cytology in human medicine has been published recently [12].Although there has been much progress in the area of pulmonary cytology in man, little use has been made of pulmonary cytology in animals except for trans-tracheal wash techniques [1,4,5]. References to bronchoscopic collection of cytologic specimens in animals are limited [15,16,17]; it has not been widely used in veterinary medicine for several reasons. First, the incidence of spontaneous pulmonary neoplasms is quite low. Second, fiberoptic equipment necessary for adequate collection of cytologic specimens from the deep bronchial tree is expensive and has limited the development of pulmonary cytologic techniques to teaching hospitals and research 294

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Section: Discussionmentioning

confidence: 99%

Bronchopulmonary Lavage Cytology in the Dog: Normal Findings

1980

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Bronchoscopy‐guided transtracheal and transbronchial fine‐needle aspiration biopsy: A 5‐year institutional review of 111 cases

Xie

Cornwell

Grossman

et al. 2002

Diagnostic Cytopathology

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We reviewed 111 bronchoscopy-guided transtracheal and transbronchial fine-needle aspiration (TT/TBNA) specimens from 97 patients to determine the sensitivity and specificity for diagnosing neoplasia compared to surgical biopsy and clinical follow-up and to determine the optimal number of passes. Fifty were positive for neoplasia, seven were suspicious, one was atypical, 51 were negative, and two were unsatisfactory. Of 57 positive/suspicious cases, 56 were confirmed neoplastic, with one patient lost to follow-up (specificity with follow-up: 100%). A positive diagnosis was rendered on the first pass in 29 cases (58%), second in six (12%), third in five (10%), fourth in three (6%), fifth in four (8%), and sixth, ninth, and eleventh passes in one case each (2% each). Twenty-seven negative cases had confirmed malignancies after their index FNA (sensitivity for neoplasia: 67%). We conclude that TT/TBNA is a highly specific but not always successful diagnostic technique. It appears to be limited by mechanical difficulties that prevent tumor access and cellular uptake in some masses. Little information is gained by procuring more than six samples.

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