Cytology of bronchial biopsy rinse fluid to improve the diagnostic yield for lung cancer

Sampling techniques are combined during bronchoscopy to increase the diagno stic yield for endobronchial malignant tumours, Bronchial biopsy provides t he definitive histological diagnosis in most cases, but accompanying cytolo gical procedures such as washing, brushing, needle aspiration or imprint cy tology can increase diagnostic yield,In this prospective study, a different cytological technique, that could enhance the diagnostic yield of bronchos copy without increasing its time or cost, was tested. Flexible bronchoscopy was performed in 93 patients suspected of having pulm onary neoplasms. Bronchial biopsies were initially placed in a balanced sal t solution. When bronchoscopy was finished, all visible tissue fragments we re removed and placed in formalin to undergo histopathological examination and the rinse fluid was sent for cytological examination. Washing was perfo rmed routinely but no cytological brushing was employed. Eighty-two patients had final diagnoses of malignant neoplasm, In four (4.8 %) of these patients, the only positive result came from the cytological ex amination of the bronchial biopsy rinse fluid. No false-positive results we re found. The agreement with the histological results was 81.8%. The additi on of bronchial biopsy rinse-fluid examination increased the sensitivity of bronchoscopy from 65.8% to 70.7% (McNemar's p=0.009). The cytological study of bronchial biopsy rinse fluid offers reliable posit ive results in an additional 4.8% of cases, thus enhancing bronchoscopic di agnostic yield for malignant endobronchial tumours while neither prolonging the procedure nor increasing costs.