Value and accuracy of cytology in addition to histology in the diagnosis of lung cancer at flexible bronchoscopy

There is still disagreement as to the value and reliability of wash and bru sh cytology. in comparison with histology, For the diagnosis of malignancy at flexible bronchoscopy. The present study compares the yield and concorda nce of findings from the two modalities for visible tumours at flexible bro nchoscopy. A single-centre study of 514 consecutive flexible bronchoscopy procedures. in which a lesion suspicious of cancer M as seen and bronchial wash cytolog y, brush cytology and forceps biopsy samples were taken. All equivocal or s uspicious results were taken as negative. An overall yield of 89(.)3% was achieved using a combination of all three t ests. This was greater fur endobronchial than submucosal(95% vs. 86%) tumou rs. Cytology alone diagnosed 17(.)7% of cases. Use of all three modalities allowed tumours to be differentiated between small and non-small cell types in all but 5/459 positive cases (98(.)9%). There were only 3/313 cases in which there was a difference in cell type (small cell vs. non-small cell) b etween the two modalities. We conclude that wash and brush cytology are valuable tools, in addition to forceps biopsy. at flexible bronchoscopy. All three tests should be perfor med routinely in cases of suspected malignancy.