title: Prospective study of combined use of bronchial aspirates and biopsy specimens in diagnosis and typing of centrally located lung tumours.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of examining bronchial secretions in pulmonary cytopathology and whether cytology and histopathology can complement each other in routine practice among lung specialists.
  
  
  METHODS
  A prospective study comparing 1225 cytological and biopsy results, conducted during 1987-93. Tumours were confirmed by histopathology, imaging techniques, or clinical outcome and imaging techniques combined.
  
  
  METHODS
  11 lung or internal medicine units, France.
  
  
  METHODS
  1128 patients (874 men; 254 women) aged 65.3 (SD 13.7) years who underwent fibreoptic bronchoscopy for various pulmonary symptoms.
  
  
  RESULTS
  Exact concordance between cytological and biopsy results was obtained in 1036/1187 (87.3%) satisfactory specimens. In all 574 lung tumours were diagnosed. One case (0.08%) was a false positive cytological diagnosis in a patient with tuberculosis. Patients with lung cancer were more likely to have positive cytological results than positive biopsy results (P < 0.001). Agreement in tumour typing was observed in 375/424 (88.4%) cases, when non-small cell carcinomas, small cell carcinomas and undifferentiated carcinomas were separated. In the 11 patients with squamous cell carcinomas in situ, eight (72.7%) of the carcinomas were diagnosed cytologically as squamous cell. Unsatisfactory material was obtained in only 20 (1.6%) and 19 (1.6%) cases by cytology and biopsy respectively. Examinations had to be repeated in 86 (7.6%) patients.
  
  
  CONCLUSIONS
  Examination of bronchial secretions complements histopathology in both diagnosing and typing lung tumours and could be performed more systematically in patients undergoing fibreoptic bronchoscopy.
authors.affiliation: Clinical Cytopathology Laboratory, Lyon Grange-Blanche Medicine Faculty, Domaine Rockefeller, Lyons, France.
authors.forename: E
authors.initials: E
authors.lastname: Piaton
authors.forename: M H
authors.initials: MH
authors.lastname: Grillet-Ravigneaux
authors.forename: B
authors.initials: B
authors.lastname: Saugier
authors.forename: H
authors.initials: H
authors.lastname: Pellet
mesh_terms: D000368:Aged; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology*; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D011446:Prospective Studies