Assessment of diagnostic efficacy of BAL and FNAC with reference to biopsy in suspected cases of pulmonary malignancy

Authors : Chilamakuru Raghavendra, Chilamakuru Raghavendra, G Ram Kumar Gupta, G Ram Kumar Gupta, V Venkata Ramana Reddy, V Venkata Ramana Reddy

DOI : 10.18231/2581-4222.2019.0007

Volume : 4

Issue : 1

Year : 2019

Page No : 27-31

Background: Lung cancer is amongst the most commonly diagnosed major cancers. It is important to diagnose lung cancers as early as possible before the lesion has reached a visible and palpable tumor. This study was intended to find out efficacy of various diagnostic modalities in identifying pulmonary malignancies for easy and early diagnosis.
Aims: To assess the efficacy of BAL and FNAC in suspected cases of pulmonary malignancy.
Methodology: Prospective, observational study conducted in a tertiary care institute over a period of four years.
115 consecutive cases of suspected bronchogenic carcinoma were admitted. BAL and FNAC and biopsy were done to all the patients. Biopsy is taken as gold standard for comparison of BAL and FNAC to found the diagnostic efficacy in identifying pulmonary malignancy.
Results: Out of the 107 cases of pulmonary malignancy, the most common type was Adenocarcinoma followed by squamous cell carcinoma and small cell carcinoma. Sensitivity of BAL was found to be 39.25% and FNAC was found to be 97.19%. Specificity was found to be 100% for both FNAC and BAL. Positive predictive value and negative predictive value was better with FNAC than that of BAL.
Conclusions: Image guided FNAC of pulmonary lesions is a simple, safe, less expensive technique with low morbidity and leads to early and quick diagnosis when compared to trucut biopsy. In this study combination of BAL and FNAC can establish the diagnosis of bronchial carcinoma in most cases. Although histopathology remains the gold standard for diagnosis one can rely on cytology techniques for quick reporting of lung lesions.

Keywords: BAL; Biopsy; FNAC; Pulmonary malignancy; Sensitivity; Specificity.


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