What are the diagnostic findings from a Bronchoscopy (Bronchoscopic examination)?

From the Guidelines

Bronchoscopy should be utilized to obtain samples such as bronchoalveolar lavage (BAL), bronchial brushings, endobronchial biopsies, and transbronchial biopsies to diagnose lung cancer, infection, inflammation, or interstitial lung disease. The choice of which samples to collect depends on the clinical question being investigated. According to the most recent study 1, diagnostic strategies for establishing the diagnosis of lung cancer usually include transthoracic biopsies and or bronchoscopy.

Some key points to consider when performing bronchoscopy include:

• The use of image-guided techniques, such as endobronchial ultrasound (EBUS) with radial probe, fluoroscopy, cone-beam, and electromagnetic navigation bronchoscopy, to facilitate sampling peripheral lesions and improve the detection of such lesions.
• The combination of modalities, such as bronchoscopic sampling methods with cryobiopsies, to achieve a better yield and obtain larger and better-preserved samples.
• The importance of operator skills and the prevalence of cancer in the population being screened in determining the sensitivity of bronchoscopy in detecting malignancy.

In terms of specific samples to collect, the following may be considered:

• Bronchoalveolar lavage (BAL) to collect cells and microorganisms
• Bronchial brushings to scrape cells from the airway surface
• Endobronchial biopsies to remove small tissue samples from visible lesions
• Transbronchial biopsies to obtain lung tissue samples through the bronchial wall
• Transbronchial needle aspiration (TBNA) to sample lymph nodes or masses adjacent to the airways

These specimens can be sent for cytology, histopathology, and microbiological studies, including cultures for bacteria, fungi, mycobacteria, and viruses, as well as molecular testing to detect specific genetic mutations or infectious agents 1.

From the Research

Bronchoscopy Procedures

Bronchoscopy is a valuable tool for diagnosing various airway and lung diseases, including lung cancer and airway disease. The following are some of the key aspects of bronchoscopy procedures:

• Diagnosis of pulmonary diseases: Bronchoscopy has been used to diagnose various pulmonary diseases, including lung cancer, airway foreign bodies, tumors, infectious and inflammatory conditions, airway stenosis, and bronchopulmonary hemorrhage 2, 3.
• Staging of lung cancer: Bronchoscopy is also used for the staging of lung cancer, with techniques such as white light video bronchoscopy, forceps biopsy, brush biopsy, bronchoalveolar lavage, bronchial washings, and transbronchial needle aspiration 4, 5.
• Advanced technologies: Recent advances in bronchoscopic technology include endobronchial ultrasound (EBUS), electromagnetic navigational bronchoscopy (ENB), autofluorescence bronchoscopy, narrow band imaging, optical coherence tomography, and confocal fluorescent laser microscopy 4, 3, 5.
• Diagnostic accuracy: The diagnostic accuracy of bronchoscopy procedures is an important aspect, with measures such as sensitivity, specificity, and diagnostic yield being used to evaluate the effectiveness of these procedures 6.

Benefits of Bronchoscopy

The benefits of bronchoscopy include:

• Early diagnosis of lung diseases: Bronchoscopy allows for the early diagnosis of lung diseases, which is essential for effective treatment and management 2.
• Minimally invasive: Bronchoscopy is a minimally invasive procedure, which reduces the risk of complications and allows for faster recovery times 5.
• Accurate diagnosis: Bronchoscopy provides an accurate diagnosis of lung diseases, which is essential for developing effective treatment plans 4, 3.

Applications of Bronchoscopy

Bronchoscopy has a wide range of applications, including:

• Diagnosis of lung cancer: Bronchoscopy is used to diagnose and stage lung cancer, with techniques such as EBUS and ENB being used to evaluate peripheral lung nodules 4, 5.
• Diagnosis of airway disease: Bronchoscopy is used to diagnose and manage airway disease, including conditions such as airway foreign bodies, tumors, infectious and inflammatory conditions, airway stenosis, and bronchopulmonary hemorrhage 3.
• Evaluation of lung nodules: Bronchoscopy is used to evaluate lung nodules, with techniques such as navigational bronchoscopy and radial EBUS being used to diagnose peripheral lung nodules 5.