Author/Editor		Debeljak, Andrej; Triller, Nadja; Kecelj, Peter
Title		Upogljiva bronhoskopija v diagnostiki perifernih pjučnih malignomov
Translated title		Flexible bronchoscopy in the diagnostics of peripheral lung malignant tumours
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 6, št. 15
Publication year		2001
Volume		str. 119-23
Language		slo
Abstract		The purpose of this restrospective study was to determine the value of flexible bronchoscopy in the diagnostic workup of patients with peripheral lung disease and suspected lung cancer. A total of 212 bronchoscopies were performed in 200 patients (148 men, 52 women) with peripheral lung infiltration. The indication for the procedure as suspected malignant neoplasm of the lung. Topical anaesthesia with lidocaine was applied and the Olympus 1T 30 and 1T 240 bronchoscopes were used. Bronchoscopic lung biopsy, brushing, bronchoscopic needle biopsy of mediastinal lymph nodes and, occasionally, of peripheral infiltrate, were perfomed under fluoroscopic control (Phillips BV 29). Bronchoalveolar lavage with 100 ml of 0.9% saline was done in the bronchus leading to the infiltration. Cytology and histology, and occasionally, bacteriological tests for Mycobacterium tuberculosis and non-specific bacteria were carried out. Immunological, serological and other investigations were done to exclude malignoma and establish definite diagnosis of benign lung disease. Malignant lesions were found in 86 patients (age range 63.8+/-10.1 years) and benign lung disease in 114 (age range 58.4+/-13.5 years(. The diagnosis of primary lung cancer was confirmed in 75 cases. One patient had two primary lung cancers and two patients had malignant tumours without pulmonary involvement. Metastases were found in 10 patients. Bronchoscopic lung biopsy confirmed malignoma in 69% of cases (59/85), brushing in 62% (40/65), bronchoscopic needle biopsy of mediastinal lymph nodes and peripheral tumours in 14% (13/95) and 54% (7/13), respectively, and bronchoalveolar lavage in 14% (1/7). The overall diagnostic sensitivity of bronchoscopy for confirming peripheral pulmonary malignoma was 75% (64/85). (Abstract truncated at 2000 characters).
Summary		Cilj naše retrospektivne raziskave je bil ugotoviti pomen upogljive bronhoskopije v diagnostični obdelavi bolnikov s perifernimi infiltrati in sumom na pljučnega raka. Pri 200 bolnikih (148 moških, 52 žensk) s perifernimi boleznimi smo naredili 212 bronhoskopij. Indikacija je bila sum na periferni pljučni malignom. Uporabili smo lokalno anestezijo z Lidokainom ter Olympusove bronhoskope 1T 30 ter 1T 240. Pod fluoroskopsko kontrolo z rentgenskim aparatom Phillips BV 29 smo napravili bronhoskopsko pljučno biopsijo, krtačenje ter bronhoskopsko igelno biopsijo mediastinalnih beygavk, občasno tudi perifernega infiltrata. Bronhoalveolarni izpirek s 100 ml fiziološke raztopine smo delali v bronhiju, ki je vodil v infiltrat. Vzorce smo pregledovali citološko, histološko, občasno tudi bakteriološko na Mycobacterium tuberculosis ter nespecifične bakterije. Za opredeljevanje benignih bolezni smo uporabljali tudi imunološke, serološke ter druge internistične preiskave. Pri 86 bolnikih (starost 63,8+/-10,1 leto) smo našli maligne in pri 114 (starost 58,4+/-13,5 let) benigne bolezni. Primarni pljučni rak smo našli 75 krat (eden od bolnikov je imel dva raka, pri dveh bolnikih z malignomi pljuča niso bila prizadeta) in zasevke pri 10 bolnikih. Bronhoskopska pljučna biopsija je potrdila malignom pri 69% (59/85), krtačenje pri 62% (40/65), bronhoskopska igelna biopsija mediastinalnih bezgavk pri 14% (13/95) in perifernih tumorjev pri 54% (7/13) ter bronhoalveolarni izpirek pri 14% (1/7). Občutljivost bronhoskopije pri dokazovanju perifernega malignoma v celoti je bila 75% (68/85). Kadar je bila bronhoskopija nediagnostična smo uporabili transtorakalno igelno biopsijo (n=16), torakotomijo (n=3), igelno biopsijo periferne bezgavke (n=1) ali vratno mediastinoskopijo (n=1). Za opredeljavnje perifernega pljučnega infiltrata ima bronhoskopija pomembno mesto. (Izvleček prekinjen pri 2000 znakih).
Descriptors		LUNG NEOPLASMS BRONCHOSCOPY BIOPSY