Methylene blue-aided in vivo staining of central airways during flexible bronchoscopy.
BACKGROUND
The early diagnosis of malignant and premalignant changes of the bronchial mucosa remains a major challenge during bronchoscopy. Intravital staining techniques are not new. Previous small case series suggested that analysis of the bronchial mucosal surface using chromoendoscopy allows a prediction between neoplastic and nonneoplastic lesions.


OBJECTIVE
The aim of the present study was to evaluate chromobronchoscopy as a method to identify malignant and premalignant lesions in the central airways in a prospective manner.


METHODS
In 26 patients we performed chromoendoscopy with 0.1% methylene blue during ongoing flexible white light bronchoscopy. Circumscribed lesions in central airways were further analyzed by biopsies and histopathologic examination.


RESULTS
In the majority of cases neither flat nor polypoid lesions in the central airways were stained by methylene blue. In particular, exophytic growth of lung cancer did not show any specific pattern in chromobronchoscopy. However, a specific dye staining was detected in one case where exophytic growth of metastatic colorectal cancer was present in the right upper lobe. In two other cases, a circumscribed staining was noted in unsuspicious mucosa. But histology revealed inflammation only.


CONCLUSIONS
In contrast to previous studies, the present findings clearly indicate that chromobronchoscopy is not useful for early detection of malignant or premalignant lesions of the central airways.
Department of Medicine, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. sabine.zirlik@uk-erlangen.de
Sabine
S
Zirlik
Kai M
KM
Hildner
Markus F
MF
Neurath
Florian S
FS
Fuchs
D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000175:diagnosis*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis*
D008751:Methylene Blue