Flexible fiberoptic bronchoscopy (FOB) as a diagnostic tool in endobronchial lesions

Abstract

Introduction: Flexible fiberoptic bronchoscopy (FOB) has revolutionized the way pulmonary lesions are diagnosed, especially when endobronchial involvement is suspected. We aimed to evaluate the role of FOB by comparing the efficacy of forceps biopsy, bronchial brushings, and bronchial washings individually and in combination. Materials and Methods: This study was performed on 40 patients whose diagnosis was uncertain despite various diagnostic techniques. After initial screening, FOB was performed on patients suspected of endobronchial tumor. During the procedure of biopsy, brushings and washings were collected and sent for microbiology, cytology, and histopathology. The criteria for FOB included chronic cough, recurrent hemoptysis, and abnormal radiological opacity. Results: Twenty-five patients had visible endobronchial tumor, mean age of presentation was 41-70 years, and males were predominant. The chief complaint was cough followed by persistant fever. Lung cancer (84%) was the most common etiology followed by tuberculosis (TB) (16%). Bronchial brushings gave the highest yield, slightly higher than forceps biopsy. Conclusion: FOB is a very useful and safe diagnostic technique for the evaluation of endobronchial tumor. Because of the high prevalence of TB, the possibility of TB should be considered next to lung cancer. Bronchial brushings has an advantage over forceps biopsy in situations where biopsy forceps cannot reach or open at the site of growth.

Keywords

• Endobronchial tumor
• fiberoptic bronchoscopy (FOB)
• lung cancer
• tuberculosis (TB)