[Usefulness of induced sputum cytology in the study of central masses in elderly patients].
OBJECTIVE
To analyze the diagnostic yield of cytology obtained by means of sputum induction in elderly patients with central masses.


METHODS
A total of 23 patients older than 75 years with centrally located pulmonary masses identified by computerized tomography were studied. All patients collected three spontaneously produced sputum specimens and underwent three sputum-induction sessions. Induction was considered satisfactory when the patient expectorated within the following 15 minutes. All sputum specimens were processed by May-Grünwald-Giemsa and Papanicolau staining techniques. The definite diagnostic was considered that obtained by means of bronchial biopsy or chest percutaneous aspirative puncture (PAP).


RESULTS
With sputum induction, 19 patients (83%) collected satisfactory specimens and in 14 cases cytology was positive for malignancy (sensitivity 74%) and negative in five. No false-positive cases were recorded and in no patient did complications occur in association with sputum induction. The analysis of agreement between induced sputum and definite diagnosis showed a kappa index of 0.66.


CONCLUSIONS
Among elderly patients with central pulmonary masses, the cytology of induced sputum should be considered as the first diagnostic procedure because of its harmlessness, remarkable sensitivity and high histologic correlation.
Alonso Fernández
A
A
Servicio de Neumología, Hospital Universitario La Paz, Facultad de Medicina, Universidad Autónoma, Madrid.
García Río
F
F
Mayoralas Alises
S
S
Sánchez Fraga
S
S
Mediano San Andrés
O
O
Villamor León
J
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D013183:Sputum / Q000166:cytology*