USE OF FIBEROPTIC BRONCHOSCOPY IN THE DIAGNOSIS OF BRONCHOGENIC-CARCINOMA - A STUDY IN PATIENTS WITH IDIOPATHIC PLEURAL EFFUSIONS

We reviewed our experience with 115 patients with pleural effusion in whom bronchogenic carcinoma was suspected who underwent fiberoptic bro nchoscopy (FOB) to identify those for whom the procedure was useful. I n 6 of 12 patients with hemoptysis, 8 of 12 with a mass or infiltrate, and 8 of 18 with atelectasis with negative fluid cytology and 3 of 7 with cytology positive, FOB was useful in diagnosis. Sixty-six patient s had an isolated cytology-negative effusion. Seven of 18 with massive effusion had FOB detecting cancer. Fiberoptic bronchoscopy usually wa s nondiagnostic in lesser-sized effusions (47 of 48). Using outcome fo r those with nondiagnostic FOB, we established operating characteristi cs for the procedure. We conclude that FOB is useful in diagnosing bro nchogenic carcinoma in such patients when there is hemoptysis, accompa nying lung mass or infiltrate, atelectasis, the effusion is massive, o r in cytology-positive effusions without obvious primary tumor. Due to the low prevalence of bronchogenic carcinoma in patients with effusio ns of lesser size, we suggest that in this group FOB not be routinely performed.