A Study on Accuracy of Respiratory Cytology for Cancer Diagnosis.

Surekha, M R (2006) A Study on Accuracy of Respiratory Cytology for Cancer Diagnosis. Masters thesis, Kilpauk Medical College.

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Abstract

Sputum Cytology Has Been The Traditional Focus For Teaching Respiratory Cytology For Many Years. However The Emphasis Has Been Altered By The Introduction Of Fiberoptic Bronchoscopy (Fob) And Fine Needle Aspiration22. Recent Developments In Sampling Techniques Have Changed The Practice Of Respiratory Tract Cytology, Although New Methods Have Not Completely Supplanted More Traditional Ones. Methods For Obtaining Cell Samples From The Respiratory Tract Include Sputum, Bronchial Brushing, Bronchial Washing, Bronchioalveolar Lavage, Transbronchial Needle Aspiration, Transthoracic Fine Needle Aspiration And Endoscopic Ultrasonography Guided Fine Needle Aspiration. Each Of These Methods Has Advantages And Limitations. Bronchial Brushings, Washing, Fine Needle Aspiration And Lavage Procedures Usually Yield Better Diagnostic Material Than Is Obtained By Simple Exfoliative Sampling22. Bronchial Washing Is Complementary To Brushing When An Endobronchial Lesion Is Observed And Superior To Brushing When The Lesion Is Beyond The Reach Of The Brush. It Is Also Helpful In The Diagnosis Of Peripheral Lung Lesions With Submucosal Or Peribronchial Tumour Spread18. Washings Are Sent As Part Of The Procedure And Are Routinely Processed And Add A Small Increment To Sensitivity, Mainly When Brush Or Biopsy Cannot Reach More Peripheral Tumours22. Bronchioalveolar Lavage Is Another Technique Particularly Useful When A Diffuse Infiltrate Is Seen On The X-Ray And An Opportunistic Infection Or Lymphangitic Spread Of Tumour Is Suspected. The Bronchioalveolar Lavage May Provide A Higher Yield Than Bronchial Washing For Diagnosis Of Peripheral Tumours, Particularly Adenocarcinoma And Bronchioloalveolar Carcinoma. The Bronchoscopic Approach To The Diagnosis Of Tumours Of The Tracheobronchial Tree Is Guided Primarily By The Size And Location Of The Tumour. A Combination Of Cytologic Modalities Is Often Performed With Or Without Forceps Biopsy To Increase The Diagnostic Yield18. Central Bronchogenic Lesions May Present As An Exophytic Mass, A Submucosal Or Infiltration Lesion Or Extrinsic Bronchial Compression And Narrowing. The Use Of Fiberoptic Bronchoscopic Instruments And Simultaneous Recording Of The Findings On Videotape For Future Review Has Significantly Enlarged The Ability To Localise Early Lesions. Roughening And Redness Of The Bronchial Epithelium, Especially In The Areas Of Bronchial Spurs And In Areas Of Bronchial Subdivisions, May Signal An Important Lesion. Bronchial Brushing Of Such Areas For Cytologic Examination And Biopsies Of Even Tiny Lesions Are Now Technically Feasible And Have Been Successfully Implemented13. While Forceps Biopsy Is Suitable For Endobronchial Mass Lesions, Bronchial Brushing Allows Sampling Of A Larger Mucosal Area. If The Mucosa Appears Grossly Normal, However, Little Or No Information May Be Obtained18. Combined Study Of Cytology And Biopsy Material Enhances The Sensitivity Of Diagnosis Of Malignant Tumours And Their Specific Subtyping. The Combined Use Of Cytology And Biopsy Facilities Accurate Classification Of The Tumour Type, Since Cytologic Samples Often Provide Better Morphologic Preservation Of The Cells And Lower Likelihood Of Crushing Artifacts (Particularly In Small Cell Carcinoma), Whereas Histologic Samples Better Demonstrate Tissue Architecture And Provide More Material For Ancillary Techniques Such As Immuno Histochemistry. Thus, Even In The Presence Of An Endobronchial Lesion, Collection Of Cytologic Samples Is Recommended In Addition To Forceps Biopsy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Respiratory Cytology ; Accuracy ; Cancer Diagnosis.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 27 Jun 2017 11:36
Last Modified: 27 Jun 2017 11:36
URI: http://repository-tnmgrmu.ac.in/id/eprint/472

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