Tuberc Respir Dis.  1986 Sep;33(3):158-165. 10.4046/trd.1986.33.3.158.

Diagnostic Value of Flexible Bronchofiberscopy in Various Pulmonary Diseases

• KMID: 2528695
• DOI: http://doi.org/10.4046/trd.1986.33.3.158

Abstract

It is well known that flexible fiberoptic bronchoscopic examination is one of the best available method for the diagnosis of various pulmonary disease. For the assessment of diagnostic yield, We observed clinically with analysis 362 patients in various pulmonary diseases who had taken flexible bronchofiberscopy in the Department of Internal Medicine , Inchon Christian Hospital, Inchon from March 1982 to December 1985. The following results were obtained: 1) Transnasal route was the standard procedure πith local anesthesia by 4% Lidocaine with premedication of; Demorol and atropine. These procedure were found to easy for the operators and the acceptance to the patients was good with less discomfort to them. 2) Each bronchoscopic diaεnosis in the 362 cases was classified as follow s: lung cancer 166 cases(45. 8%) , pneumonia 52 cases (1 4. 3%) , tuberculosis 44 cases (1 2. 2%) , bronchitis 42 cases (11. 6%) , bronchiectaüs 18 cases (5.0%) , lung abscess 8 cases (2.2%) mediastinal disease 2 cases(0.6%) pleurisy 13 cases(3, 6%) other 11 cases(3.0%) undiagnosed 6 cases( 1. 7%). 3) The classificaiion of the primary lung cancer confirmed histologically was squmous carcinoma 97 cases(58.4%) adenocarcinoma 25 cases(15.1%) undifferentiated carcinoma 11 cases(6. 7%) , oat cell carcinoma 12 cases(7. 2%) , metastatic carcinoma 8 cases(4.8%) and undetermined carcinoma 13 cases(7. 8%). 4) The diagnostic yield of fiberoptic bronchoscopy for lung cancer was 91. 0% and the histological confirmed rate was 74.1%, in our seried and confirmed the diagnosis by identifying the pathologic bronchial abnormality, abnormll biopsy results and cytologic study. 5) The most prevalent age was 6 & 7 th decades and male to female ratio was 4.9: 1 Localization chest film, right was more than left(right 97 cases) (58. 4%) , left 69 cases (41. 6%) , the ratio is 1. 4: 1) and the most frequent site is right upper lung field(40 cases , 24.1%). 6) We could not differentiate the various inflammatory lung diseases by bronchofiberscopγ only. Bult in the bronchofiberscopic examination of various inflammatory lung diseases, we observed the nature of the wall and lumen of bronchus, resulting as follows: in bronchitis and pneumonia， the bronchial wall appeared as edema and hyperemia and the bronchial lumen showed normal finding in pulmonary tuberculosis and bronchiectasis, the bronchial wall showed edema, hyperemia, exudate, and bleeding and bronchil lumen rEvealed stenosis and deformity, especially luminal widening as a characteristic finding in bronchiectasis. Lung abscess had purulent discharge on the bronchial wall and s showed normal lumen of the bronchus. 7) No significant complication were experienced except a few cases of transient hemoptysis, mild nasal bleeding, or mild dyspnea among the elderly patients.