title: Multiple brushings with immediate Riu's stain via flexible fibreoptic bronchoscopy without fluoroscopic guidance in the diagnosis of peripheral pulmonary tumours.
abstract: BACKGROUND
  Accurate diagnosis of peripheral pulmonary lesions usually relies on fluoroscopic guided procedures. As fluoroscopy is not routinely available in many respiratory units, an approach not using fluoroscopy but with a high diagnostic yield is highly desirable.
  
  
  METHODS
  Immediate cytological examination of multiple brushings using Riu's stain, a modified Wright's stain, was performed in 38 patients with peripheral pulmonary lesions not visible at bronchoscopy. The results were compared with the final diagnoses determined by histological examination or subsequent Papanicolaou staining of cytological specimens and clinical course.
  
  
  RESULTS
  Of the 38 patients 29 were subsequently confirmed to have a malignant tumour. Our method provided a diagnosis of malignancy in 86% of these lesions. The accuracy (91%) and sensitivity (88%) were higher for lesions > 3 cm in diameter than for those of diameter < or = 3 cm (87% and 83%). There were no false positive results. The 29 lesions correctly diagnosed as malignant by Riu's stain required significantly fewer brushings (mean (SD) 3 (2)) than the nine benign lesions (5 (4)).
  
  
  CONCLUSIONS
  This technique provides a high diagnostic yield, avoids the need for fluoroscopy, and is probably safer than percutaneous biopsy.
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Lee
authors.forename: C H
authors.initials: CH
authors.lastname: Wang
authors.forename: M C
authors.initials: MC
authors.lastname: Lin
authors.forename: T C
authors.initials: TC
authors.lastname: Tsao
authors.forename: R S
authors.initials: RS
authors.lastname: Lan
authors.forename: Y H
authors.initials: YH
authors.lastname: Tsai
authors.forename: H P
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000473:pathology*; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013194:Staining and Labeling