Indication of Flexible Fiberoptic Bronchoscopy and the Histopathological Examination in 500 Patients

Abstract

Introduction: The importance of flexible fiberoptic bronchoscopy (FFB) for diagnosis of pulmonary diseases is well known. The aim of this study was to evaluate the indications of 500 FFBs performed in Imam Reza hospital, Mashhad, Iran as well as examination of the histopathological and radiological findings.<br />Material and Methods: This was a retrospective analysis of the medical records and chest radiologic examinations of 500 patients who had undergone FFB using Olympus BFP20 instrument by local anesthesia in, Mashhad, Iran. The indications for procedures, demographic data, and clinical symptoms were recorded and analyzed in addition to radiological and histopathological findings.<br />Results: The most common indication for FFB was found to be bronchogenic carcinoma (n=20), followed by tuberculosis (TB; n=16), sarcoidosis (n=2), and hydatid cyst (n=2). A total of 70 anthracosis cases were reported to be accompanied with other pulmonary disorders and findings such as chronic granulomatous bronchitis suspicious of TB (n=16), squamous cell carcinoma (SCC; n=5), non-specific macrophage cells in cytology (n=19), anthracotic pigment with no risk of lung cancer (n=20), anthracofibrosis (n=4), severe anthracotic pigment with undetectable mucus layer (n=2), anthracotic pigment with non-specific inflammation (n=1), mild squamous metaplasia (n=1), and chronic bronchitis with mild squamous metaplasia (n=2). Lung cancer showed higher frequency in women and patients in the sixth and seventh decades of their lives and was associated with smoking. It is worthy to note that SCC was the most prevalent cancer among the smokers. Twenty cases were diagnosed as bronchogenic carcinoma by clinical findings, eighteen of which also being confirmed by the histological examinations. Moreover, two cases of sarcoidosis diagnosis using FFB were approved by biopsy. Out of 297 bronchial biopsies, the most common indication for FFB were airway collapse and unknown pulmonary opacity.<br />Conclusion: Considering the important role of FFB in the diagnosis of pulmonary diseases, especially cancers, it seems that various diagnostic measures should be taken into consideration before disease progression. According to our evaluations, patient screening by the family physicians is recommended for the patients with cancer or TB as the two most prevalent diseases in our study.