EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 4.897

 ICV - 79.57

Abstract

DIAGNOSTIC UTILITY OF BRONCHOSCOPY IN BRONCHOSCOPICALLY NONVISIBLE (PERIBRONCHIAL) TUMORS INCLUDING TBNA: STUDY OF 150 CASES IN TERTIARY CARE SETTING IN INDIA

Sanjay Mundkar and Patil Shital*

ABSTRACT

Background: Lung cancer is the leading cause of cancer deaths around the world. Globally, lung cancer is the largest contributor to new cancer diagnosis and to death from cancer. Various conventional diagnostic techniques (CDTs) such as endobronchial forcep biopsy (FB), bronchial washing (BW) and bronchial brushing (BB), and transbronchial needle aspiration cytology (TBNA) are employed during fiber-optic bronchoscopy. Methods: Prospective, two tertiary care center study conducted between November 2012 and February 2014 at Bronchoscopy unit of MIMSR Medical College Latur, & Venkatesh chest hospital Latur India, to find the role of TBNA in bronchoscopically nonvisible (peribronchial) lesions (PBL) in confirming the diagnosis of lung cancer and to find additive yield over other techniques such as BB, BW and FB, and included 150 patients on the basis of clinical and radiological features of malignancy. In Peribronchial lesions during bronchoscopy documented findings are narrowing of airway due to extrinsic compression by tumour or Lymphadenopathy, or predominant feature of ‘bulge’ seen in the lumen. TBNA, FB, BB and BW were performed in all the cases during FOB. Histopathological and cytological examinations of specimens were performed at Pathology department. The statistical analysis was done using chi square test. Results: Total 150 patients, on the basis of clinical and radiological signs of malignancy, between age group 21-87 years with mean age 59.16 years. Males were 81.33% of total, of which 79% were smoker with 57.87% cases were having >40 pack years smoking history. Commoner symptoms were cough (92.33%), Shortness of breath (66.33%) & chest pain (61.33%), while commoner radiological presenting features were hilar mass (51%), parahilar opacity (21%), collapse segmental/lobar (18%). In PBL, diagnostic yield of TBNA, FB & CDTs were 68.66% & 27.33% & 41.33% respectively. Additional CDTs like BB cytology and BW has additive yield to FB from 27.33% to 41.33% in PBL (P<0.00001). Sensitivity of TBNA in PBL is 96.19% while that of CDTs is 59 (P<0.00001). IHC on TBNA specimens had increased histological type confirmation. Conclusion: Transbronchial needle aspiration is a beneficial, safe and minimally invasive bronchoscopic technique with insignificant side effect in the diagnosis bronchogenic carcinoma. TBNA in peribronchial lesions is most sensitive modality over conventional techniques and considered as ‘gold standard’ in these lesions. TBNA will definitely decrease need for repeat bronchoscopy.

Keywords: TBNA, Bronchoscopy, peribronchial lesions (PBL), Lung cancer.


[Full Text Article]

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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (Under Process)