Fiber-optic bronchoscopy for diagnosing hilar masses of the lung: a study from a tertiary care cardiothoracic and vascular centre in northeastern India

Cardio thoracic and vascular surgery

Abstract

Introduction: Fiberoptic Bronchoscopy is an important tool at a clinician's disposal for managing various pulmonary pathologies both benign and malignant. Its sensitivity and specificity highly depend on the site of the pulmonary lesion with central lesions providing better results than peripheral ones. The procedure is usually well tolerated if done properly with most complications being amendable to conservative management. Specially for hilar masses of the lung bronchoscopy not only allows for obtaining biopsy tissue but also evaluation of the anatomy for operative planning.

Materials and methods: Herein we review the findings and complications of Bronchoscopy done for Hilar masses at our institute from 01/05/23 to 01/12/23.  In our study we included patients who had hilar lung masses on imaging and patients who did not have prior biopsy/FNAC. Patients with peripheral lung lesions and patients who had a performance status of Eastern Cooperative Oncology Group more than 2 were excluded from the study.

Results: The results for the 20 cases taken up for bronchoscopy were as follows: A definite lesion could be identified for biopsy in 14 cases, and samples biopsied and sent for HPE (Histopathological evaluation) and IHC (immunohistochemistry) were mostly adequate. The sensitivity of bronchoscopy was found to be 70%. The procedure was well tolerated and of the total number of patients taken up for bronchoscopic biopsy only two patients had complications and these complications were managed conservatively without the need for further procedure.

Conclusion: In this study bronchoscopy and biopsy were found to be a safe and effective tool in the management of hilar masses of lung. The study is not without limitations though which include the short study duration, limited sample size, and absence of bronchoscopic ultrasound technology at our institute.