Use of the Bronchofiberscope for Bronchial Brush Biopsy

Diagnostic Results and Comparison with Other Brushing Techniques

¹ Departments of Medicine and Surgery, University of Iowa College of Medicine, Iowa City, Iowa

The flexible bronchofiberscope was used to perform bronchial brush biopsies in 75 patients with central, midlung and peripheral lung lesions suspected of being malignant. Of the 52 patients who had lung cancer, a positive or highly suspicious cytology was obtained in 46 (89 percent), compared to a diagnostic accuracy of 72 percent in a previous series using rigid, premolded catheters, and 82 percent using a mobile, controlled-tip catheter. Direct placement of the brush on endoscopically visible tumors produced positive results in 32 of 34 patients (94 percent), whereas only 14 of 18 patients (78 percent) with peripheral bronchogenic carcinomas were correctly diagnosed by indirect fiberoptic brushing under fluoroscopic control. In distal, inaccessible lesions, the problem may be solved using a mobile, controlled-tip catheter or the recently modified curette.