Background: Flexible fiber-optic bronchoscopy (FFB) is a well-established procedure in pulmonary medicine but still underutilized in rural area of developing countries where patients are still managed without confirmation of diagnosis. It is considered as an important tool in the diagnosis and therapy of varieties of pulmonary diseases.
Objective: To study the role of bronchoscopy in diagnosis of different pulmonary diseases such as tuberculosis, pneumonia, and lung cancer.
Materials and Methods: All consecutive FFB were retrospectively reviewed using bronchoscopy reports and corresponding patientÂ’s charts over 2 years. Demographic data were recorded including age, gender with indication for procedure, radiographic findings, suspected diagnosis, bronchoscopy findings, and final diagnosis.
Results: Infections including tuberculosis and malignancy were two main indications for performing bronchoscopy. The overall diagnostic yield with bronchoscope was 62%. Tuberculosis was diagnosed in 50% of suspected cases, whereas bacterial and fungal pneumonia were diagnosed in 60% of suspected lower respiratory tract infections (bacterial 83% and fungal 17%). Seventy-five percent of patients had community-acquired pneumonia and 25% had hospital-acquired pneumonia. Gram positive organisms were isolated in 25% cases, Gram negative in 70% of cases and in 5% cases mixed growth was present. Malignancy was confirmed in 68% of suspected cases (squamous cell 44%, adenocarcinoma 24%, small cell 4%, undifferentiated 24%, and metastatic carcinoma 4%). In other diseases, such as pulmonary eosinophilia, interstitial lung diseases, upper airway abnormality, and pseudo hemoptysis, it helped to establish the diagnosis.
Conclusion: Diagnostic yield of FFB in our study is fairly comparable to other studies and its widespread use is recommended in order to achieve confirmation of diagnosis, to diagnose malignancy timely, and to prevent overenthusiastic empirical use of anti-tuberculoses drugs, which can eventually prevent resistance in rural area also.
Key words: Flexible fiber-optic bronchoscopy (FFB), diagnostic yield, tuberculosis, malignancy
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