Comparison of bronchoalveolar lavage fluid cytology, cell block preparation, and bronchial biopsy in the diagnosis of lung lesions.

Introduction: Lung carcinoma is the leading cause of cancer-related mortality. Histopathological diagnosis of bronchial tissue biopsy is considered the gold standard for the diagnosis of lung tumors. The study aims to determine the spectrum of lung lesions and compare the diagnosis by cytological study of bronchoalveolar lavage (BAL) fluid, histopathological study of cell block preparation, with histopathological study of bronchial biopsy in suspected lung lesions. Material and methods: The study was carried out in the Pathology department, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Sola, Ahmedabad, Gujarat, for a period of 3 years. Comparison of diagnoses made by cytological study of BAL fluid, histopathological study of cell block preparation, and histopathological study of bronchial biopsy in suspected lung lesions was done, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of each method were calculated. Results: Out of 72 cases which were included in the study, a diagnosis of malignancy was given in 42(58.33%) cases by histopathological examination of lung biopsy, the cytological diagnosis of malignancy was given in 19(26.39%) cases in BAL fluid, and histopathological diagnosis of malignancy was given in 25 (34.72%) cases in cell block. The maximum number of cases was found in the age group of 51-60 years and in males. Conclusion: The gold standard method for the diagnosis of lung lesions is histopathological examination. Though the BAL fluid and cell block method was inferior to bronchial biopsy in diagnosing lung lesions, BAL fluid is more effective in peripheral lung lesions.