Yield of bronchoscopy in the diagnosis of neoplasm metastatic to lung

Received 8 May 2002; accepted 5 July 2002.

Abstract

The yield of fiberoptic bronchoscopy (FB) in the diagnosis of pulmonary metastases has not been conveniently analyzed. With the advances in the surgery of pulmonary metastases, there is a need to evaluate the diagnostic yield and the usefulness of FB to exclude other diseases with similar radiological patterns. To determine the value of FB in the diagnosis of pulmonary metastases we have retrospectively analyzed our experience in 113 patients with proven pulmonary metastases. An endobronchial lesion was identified in 57/113 (50.4%). The most frequent tumors with endobronchial lesions were thyroid (100%), head–neck (67%) and breast carcinomas (59%). The highest diagnostic yield was obtained combining techniques of brushing, washing and biopsy (72.6%); in cases with endobronchial lesions (84.2%) and with certain histological types (head–neck 100%; breast 90.9% and colon 84.6%). The most frequent radiological findings were single or multiple nodules (77.9%). Atelectasis were associated with endobronchial lesions. In conclusion, bronchoscopy is a valuable diagnostic procedure in selected patients with metastatic lung disease.

Keywords: bronchoscopist, end-scopic

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Article Outline

• Abstract

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References

REFERENCES

1. 1 Kvale PA, Bode FR, Kini S. Diagnostic accuracy in lung cancer: comparison of techniques used in association with flexible fiberoptic bronchoscopy. Chest. 1976;69:752–757. MEDLINE | CrossRef

2. 2 Zavala DC. Diagnostic flexible bronchoscopy: techniques and results of biopsy in 600 patients. Chest. 1975;68:12–19. MEDLINE | CrossRef

3. 3 Poletti V, Romagna M, Allen K. Bronchoalveolar lavage in the diagnosis of disseminated lung tumors. Acta Cytol. 1995;39:472–477. MEDLINE

4. 4 Chuang MT, Padilla ML, Terstein AS. Flexible fiberoptic bronchoscopy in metastatic cancer to the lungs. Cancer. 1983;52:1949–1951.

5. 5 Mohsenifar Z, Chopra SK, Simmons DH. Diagnostic value of fiberoptic bronchoscopy in metastatic pulmonary tumors. Chest. 1978;74:369–371. MEDLINE | CrossRef

6. 6 Ken Yoneda Y, Samuel Louie, David Shelton K. Approach to pulmonary metastases. Curr Opin Pulm Med. 2000;6:356–363. MEDLINE

7. 7 Rusch V. Pulmonary metastasectomy. Chest. 1995;107:322S–332S. MEDLINE | CrossRef

8. 8 Argyros GJ, Torrington KG. Fiberoptic bronchoscopy in the evaluation of carcinoma metastatic to the lung. Chest. 1994;105:454–457. MEDLINE | CrossRef

9. 9 Poe RH, Ortiz C, Israel RH. Sensitivity, specificity, and predictive values of bronchoscopy in neoplasm metastatic to lung. Chest. 1985;88:84–88. MEDLINE | CrossRef

10. 10 Braman SS, Whitcomb ME. Endobronchial metastasis. Arch Intern Med. 1975;135:543–547. MEDLINE

11. 11 Heitmiller RF, Marasco WJ, Hruban RH. Endobronchial metastasis. J Thorac Cardiovasc Surg. 1993;106:537–542. MEDLINE

12. 12 Albertini RE, Ekberg NL. Endobronchial metastasis in breast cancer. Thorax. 1980;35:435–440. MEDLINE | CrossRef

13. 13 Baumgartner WA, Mark J BD. Metastatic malignancies from distant sites to the tracheobronchial tree. J Thorac Cardiovasc Surg. 1980;79:499–503. MEDLINE

14. 14 Noy S, Michowitz M, Lazebaik N, Baratz M. Endobronchial metastasis of renal cell carcinoma. J Surg Oncol. 1986;31:268–270. MEDLINE | CrossRef

a Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain

b University Hospital, Guadalajara, Spain

f1 Correspondence should be addressed to: David Jiménez Castro, MD, Emergency Department, Ramón y Cajal Hospital, TFNO: 913368314, Madrid, Spain. E-mail: djc_69_98yahoo.com

PII: S0954-6111(02)91422-8

doi:10.1053/rmed.2002.1422

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