Skip to main content
NCBI home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1982 Jun;136(6):477–483.

Flexible Fiberoptic Bronchoscopy and Fluoroscopically Guided Transbronchial Biopsy in the Management of Solitary Pulmonary Nodules

David C Levin 1, Eugene C Fletcher 2
PMCID: PMC1273944  PMID: 7113195

Abstract

In our experience with fluoroscopically guided flexible fiberoptic bronchoscopy (FFB), transbronchial biopsy, bronchial brush, bronchial washing (BW) and sputum cytology (SC) in 101 patients with solitary pulmonary nodules (SPN) less than 6 cm in diameter (without endobronchial tumor), a specific diagnosis was reached via FFB in 36 cases. The diagnostic yields in primary lung malignant lesions (PLM), metastatic lesions and benign SPN were 58 percent, 28 percent and 10 percent, respectively. Size affected diagnostic efficiency considerably, with a 12 percent yield in lesions under 2 cm, a 40 percent yield in lesions 2 to 4 cm and a 63 percent yield in lesions over 4 cm. BW and SC (prebronchoscopic) did not contribute enough information to justify their cost. FFB directly affected therapy in 17 patients who were not thoracotomy candidates and may have influenced the decision for surgical treatment in another 19 patients diagnosed as having PLM. In 65 patients results of FFB were negative and the procedure did not appear to directly affect subsequent management because malignancy was not ruled out.

Full text

PDF
477

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borgeskov S., Francis D. A comparison between fine-needle biopsy and fiberoptic bronchoscopy in patients with lung lesions. Thorax. 1974 May;29(3):352–354. doi: 10.1136/thx.29.3.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Boushy S. F., Billig D. M., North L. B., Helgason A. H. Clinical course related to preoperative and postoperative pulmonary function in patients with bronchogenic carcinoma. Chest. 1971 Apr;59(4):383–391. doi: 10.1378/chest.59.4.383. [DOI] [PubMed] [Google Scholar]
  3. Ellis J. H., Jr Transbronchial lung biopsy via the fiberoptic bronchoscope. Experience with 107 consecutive cases and comparison with bronchial brushing. Chest. 1975 Oct;68(4):524–532. doi: 10.1378/chest.68.4.524. [DOI] [PubMed] [Google Scholar]
  4. Hanson R. R., Zavala D. C., Rhodes M. L., Keim L. W., Smith J. D. Transbronchial biopsy via flexible fiberoptic bronchoscope; results in 164 patients. Am Rev Respir Dis. 1976 Jul;114(1):67–72. doi: 10.1164/arrd.1976.114.1.67. [DOI] [PubMed] [Google Scholar]
  5. Jamplis R. W., Stevens G. M., Lillington G. A. Percutaneous needle aspiration biopsy of the lung. Am J Surg. 1968 Aug;116(2):243–250. doi: 10.1016/0002-9610(68)90500-x. [DOI] [PubMed] [Google Scholar]
  6. Kvale P. A., Bode F. R., Kini S. Diagnostic accuracy in lung cancer; comparison of techniques used in association with flexible fiberoptic bronchoscopy. Chest. 1976 Jun;69(6):752–757. doi: 10.1378/chest.69.6.752. [DOI] [PubMed] [Google Scholar]
  7. Levin D. C., Wicks A. B., Ellis J. H., Jr Transbronchial lung biopsy via the fiberoptic bronchoscope. Am Rev Respir Dis. 1974 Jul;110(1):4–12. doi: 10.1164/arrd.1974.110.1.4. [DOI] [PubMed] [Google Scholar]
  8. Lillington G. A. The solitary pulmonary nodule--1974. Am Rev Respir Dis. 1974 Dec;110(6):699–707. doi: 10.1164/arrd.1974.110.6P1.699. [DOI] [PubMed] [Google Scholar]
  9. Mark J. B., Marglin S. I., Castellino R. A. The role of bronchoscopy and needle aspiration in the diagnosis of peripheral lung masses. J Thorac Cardiovasc Surg. 1978 Aug;76(2):266–268. [PubMed] [Google Scholar]
  10. Moser K. M. Editorial: Solitary pulmonary nodules. JAMA. 1974 Mar 11;227(10):1167–1168. doi: 10.1001/jama.227.10.1167. [DOI] [PubMed] [Google Scholar]
  11. Nathan H. Management of solitary pulmonary nodules. An organized approach based on growth rate and statistics. JAMA. 1974 Mar 11;227(10):1141–1144. doi: 10.1001/jama.227.10.1141. [DOI] [PubMed] [Google Scholar]
  12. Radke J. R., Conway W. A., Eyler W. R., Kvale P. A. Diagnostic accuracy in peripheral lung lesions. Factors predicting success with flexible fiberoptic bronchoscopy. Chest. 1979 Aug;76(2):176–179. doi: 10.1378/chest.76.2.176. [DOI] [PubMed] [Google Scholar]
  13. Ray J. F., 3rd, Lawton B. R., Magnin G. E., Dovenbarger W. V., Smullen W. A., Reyes C. N., Myers W. O., Wenzel F. J., Sautter R. D. The coin lesion story: update 1976. Twenty years' experience with thoracotomy for 179 suspected malignant coin lesions. Chest. 1976 Sep;70(03):332–336. doi: 10.1378/chest.70.3.332. [DOI] [PubMed] [Google Scholar]
  14. Schoenbaum S. W., Koerner S. K., Ramakrishna B., Goldman M. L. Transbronchial biopsy of peripheral lesions with fluoroscopic guidance: use of the fiberoptic bronchoscope. J Can Assoc Radiol. 1974 Mar;25(1):39–43. [PubMed] [Google Scholar]
  15. Sinner W. N. Transthoracic needle biopsy of small peripheral malignant lung lesions. Invest Radiol. 1973 Sep-Oct;8(5):305–314. doi: 10.1097/00004424-197309000-00002. [DOI] [PubMed] [Google Scholar]
  16. Stringfield J. T., Markowitz D. J., Bentz R. R., Welch M. H., Weg J. G. The effect of tumor size and location on diagnosis by fiberoptic bronchoscopy. Chest. 1977 Oct;72(4):474–476. doi: 10.1378/chest.72.4.474. [DOI] [PubMed] [Google Scholar]
  17. Wilson R. K., Fechner R. E., Greenberg S. D., Estrada R., Stevens P. M. Clinical implications of a "nonspecific" transbronchial biopsy. Am J Med. 1978 Aug;65(2):252–256. doi: 10.1016/0002-9343(78)90816-1. [DOI] [PubMed] [Google Scholar]
  18. Zavala D. C. Diagnostic fiberoptic bronchoscopy: Techniques and results of biopsy in 600 patients. Chest. 1975 Jul;68(1):12–19. doi: 10.1378/chest.68.1.12. [DOI] [PubMed] [Google Scholar]
  19. Zavala D. C., Richardson R. H., Mukerjee P. K., Rossi N. P., Bedell G. N. Use of the bronchofiberscope for bronchial brush biopsy. Diagnostic results and comparison with other brushing techniques. Chest. 1973 Jun;63(6):889–892. doi: 10.1378/chest.63.6.889. [DOI] [PubMed] [Google Scholar]
  20. Zelch J. V., Lalli A. F., McCormack L. J., Belovich D. M. Aspiration biopsy in diagnosis of pulmonary nodule. Chest. 1973 Feb;63(2):149–152. doi: 10.1378/chest.63.2.149. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES