Correlation of bronchoalveolar lavage and brushings with bronchial biopsy in the diagnosis of lung malignancies - Mubarak Al-Kabeer hospital experience

Objectives: To determine the role and diagnostic utility of bronchoalveolar lavage (BAL), bronchial brushings (BB) and bronchial biopsy in the diagnosis of bronchogenic carcinoma Design: Retrospective study Setting: Cytopathology and histopathology laboratories, Mubarak Al-Kabeer hospital, Kuwait Subjects: Total of 225 cases with BB and/or BAL and bronchial biopsy reviewed from January 2010 to December 2015 Intervention: Demographical data, cytological diagnosis, histological diagnosis and tumor type were reviewed Main outcome measure: To document the efficacy of BAL and BB in the diagnosis of bronchogenic carcinoma. To the best of our knowledge, this data is not available from Kuwait. Results: Of the 225 cases, 81 (36%) were females and 144 (64%) were males, ages ranging from 12 - 83 years. In 73 bronchial biopsies with malignancy, there were 9 small cell carcinoma, 17 adenocarcinoma, 9 non-small cell carcinoma, 24 squamous cell carcinoma, 3 adenosquamous carcinoma, 5 lymphoreticular malignancy and 6 miscellaneous tumors. The cytology in these 73 cases was positive for malignancy in 8, 4 and 24 cases of BAL alone, BB alone and both BAL and BB respectively. The sensitivity, specificity, negative predictive value and positive predictive value of BAL and BB were 32.3%, 100%, 73.8%, 100% and 59.1%, 95.5%, 53.8%, 96.3% respectively. A significant association between the bronchial biopsy and BB and BAL was observed (p < 0.001). Conclusion: Combination of BB and BAL complement each other and enhance the diagnostic efficacy of lung tumors in conjunction with bronchial biopsy. Thus, all these techniques should be used concurrently to diagnose lung carcinomas.