TITLE:
Assessment of Diagnostic Accuracy of Bronchoalveolar Lavage Cytology in the Diagnosis of Lung Tumors and Contribution to the Classification of Non-Small Cell Lung Cancer Entities: A Retrospective Clinocopathological Study
AUTHORS:
Annette Zimpfer, Antonia Polak, Andrea Bier, Guenther Kundt, Jana Kölbel, Friedrich Prall, Johann C. Virchow, Andreas Erbersdobler
KEYWORDS:
Lavage Cytology; Accuracy; Lung Cancer; NSCLC; Classification
JOURNAL NAME:
Open Journal of Pathology,
Vol.3 No.3,
June
28,
2013
ABSTRACT:
Background: Due to new
therapeutic options in thoracic oncology, the pathological diagnosis of
bronchial carcinoma has become more challenging. The majority of bronchial
cancer is diagnosed from small biopsy specimens and the diagnosis often based
on cytological methods. Aims: In
this study, we reevaluated cytologic specimens in order to determine the
diagnostic reliability of pulmonary cytopathologic techniques performed in our
department. Material and methods: In
our center bronchial lavage/bronchoalveolar lavage (BL/BAL) specimens are
obtained both before and after forceps biopsy (FB) and subsequently processed.
Retrospective data from a period of 60 months were retrieved from the
institutional files. Sensitivity, specificity, as well as accuracy of
cytological tumor typing were determined using histopathology of FB as gold
standard. Also, the diagnostic yield of BL/BAL before and after FB was
determined. Results: 678 cases were
retrieved from the institutional files. The sensitivity and specificity of
cytology were 83.0% and 83.4%, respectively. By FB in 3.9% of cytologically
diagnosed non-small cell lung carcinomas (NSCLC) a histological assignment to a
NSCLC entity was not possible. Conclusions: Cytology is a reliable diagnostic tool in the diagnosis of lung
malignancies. High diagnostic accuracy is achieved by a combination of BL/BAL
before and after FB. The diagnostic yield of BL/BAL after FB was significantly
higher than BL/BAL before FB. Subsequent tumor typing of cytologically diagnosed
NSCLC was feasible in more than 95% of cases.