Abstract
The endoscopic examination of the tracheobronchial tree is most helpful in the diagnosis and staging of bronchial carcinoma. Tumors that are endoscopically visible may be confirmed in more than 95% of the cases. In localized peripheral tumors, the diagnostic yield of bronchoscopy is significantly lower; for peripheral metastases, only about 10%. In diffuse interstitial pulmonary diseases other than malignancies, some infections, and histiocytosis X, bronchoscopy including transbronchial biopsy is less successful.
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Rudd RM, Gellert AR, Boldy DA, Studdy PR, Pearson MC, Geddes DM, Shinha G (1982) Bronchoscopic and percutaneous aspiration biopsy in the diagnosis of bronchial carcinoma cell type. Thorax 37:462–465
Shure D, Fedullo PF (1985) Transbronchial needle aspiration in the diagnosis of submucosal and peribronchial bronchogenic carcinoma. Chest 88:49–51
Johnston WW, Bossen EH (1981) Ten years of respiratory cytopathology at Duke University Medical Center. II. The cytopathologic diagnosis of lung cancer during the years 1970 to 1974, with a comparison between cytopathology and histopathology in the typing of lung cancer. Acta Cytol 25:499–505
Manalo-Estrella P, Fry WA (1973) Cytologic diagnosis of lung lesions by bronchial brushing. Ann Clin Lab Sci 3:280–295
Richardson RH, Zavala DC, Mukerjee PK, Bedell GN (1974) The use of fiberoptic bronchoscopy and brush biopsy in the diagnosis of suspected pulmonary malignancy. Am Rev Respir Dis 109:63–66
Rosa UW, Prolla JC, Gastal E da S (1973) Cytology in diagnosis of cancer affecting the lung. Results in 1,000 consecutive patients. Chest 63:1203–207
Garfinkle TJ, Weisman RA, Denneny JC 3d (1981) Flexible fiberoptic bronchoscopy and pulmonary cytology in the evaluation of patients with head and neck malignancies. Ann Otol Rhinol Laryngol 90:351–353
Schaberg T, Mai J, Thalmann U, Loddenkemper R (1986) Die transbronchiale Lymphknotenpunktion ueber das Fiberbronchoskop bei pulmonalen Neoplasmen. Prax Klin Pneumol 40:306–311
Zavala DC, Rossi NP, Bedell GN (1972) Bronchial brush biopsy. A valuable diagnostic technique in the presurgical evaluation of indeterminate lung densities. Ann Thorac Surg 13:519–528
Zavala DC, Rossi NP, Rodman NF, Bedell GN, Pixley E (1972) A new mobile catheter for obtaining bronchial brush biopsies. Diagnostic results in 50 patients with suspicious pulmonary lesions and negative bronchoscopies. Am Rev Respir Dis 106:541–547
Francis D, Borgeskov S (1975) Progress in preoperative diagnosis of pulmonary lesions. Acta Cytol 19:241–244
Popovich J Jr, Kvale PA, Eichenhorn MS, Radke JR, Ohorodnik JM, Fine G (1982) Diagnostic accuracy of multiple biopsies from flexible fiberoptic bronchoscopy. A comparison of central versus peripheral carcinoma. Am Rev Respir Dis 125:521–523
Yrigoyen E, Fujikawa YF (1975) Flexible fiberoptic bronchoscopy. Anesthesia, technique and results. West J Med 122:117–122
Ono R, Loke J, Ikeda S (1981) Bronchofiberscopy with curette biopsy and bronchography in the evaluation of peripheral lung lesions. Chest 79:162–166
Shure D, Fedullo PF (1983) Transbronchial needle aspiration of peripheral masses. Am Rev Respir Dis 128:1090–1092
Radke JR, Conway WA, Eyler WR, Kvale PA (1979) Diagnostic accuracy in peripheral lung lesions. Factors predicting success with flexible fiberoptic bronchoscopy. Chest 76:176–179
Wallace JM, Deutsch AL (1982) Flexible fiberoptic bronchoscopy and percutaneous needle lung aspiration for evaluating the solitary pulmonary nodule. Chest 81:665–671
Wilson RK, Fechner RE, Greenberg SD, Estrada R, Stevens PM (1978) Clinical implications of a “nonspecific” transbronchial biopsy. Am J Med 65:252–256
Wang KP, Haponik EF, Britt EJ, Khouri N, Erozan Y (1984) Transbronchial needle aspiration of peripheral pulmonary nodules. Chest 86:819–823
Teirstein AS, Chuang MT, Choy AR, Miller A, Nieburgs HE (1978) Flexible bronchoscopy in nonvisualized carcinoma of the lung. Ann Otol Rhinol Laryngol 87:318–321
Albertini RE, Ekberg NL (1980) Endobronchial metastasis in breast cancer. Thorax 35:435–440
Chuang MT, Padilla ML, Teirstein AS (1983) Flexible fiberoptic bronchoscopy in metastatic cancer to the lungs. Cancer 52:1949–1951
Mohsenifar Z, Chopra SK, Simmons DH (1978) Diagnostic value of fiberoptic bronchoscopy in metastatic pulmonary tumors. Chest 74:369–371
Cortese DA, McDougall JC (1981) Bronchoscopic biopsy and brushing with fluoroscopic guidance in nodular metastatic lung cancer. Chest 79:610–611
Nishio JN, Lynch JP 3d (1980) Fiberoptic bronchoscopy in the immunocompromised host: The significance of a “non-specific” transbronchial biopsy. Am Rev Respir Dis 121:307–312
Wall CP, Gaensler EA, Carrington CB, Hayes JA (1981) Comparison of transbronchial and open biopsies in chronic infiltrative lung diseases. Am Rev Respir Dis 123:280–285
Roethe RA, Fuller PB, Byrd RB, Hafermann DR (1980) Transbronchoscopic lung biopsy in sarcoidosis. Optimal number and sites for diagnosis. Chest 77:400–402
Gilman MJ, Wang KP (1980) Transbronchial lung biopsy in sarcoidosis. An approach to determine the optimal number of biopsies. Am Rev Respir Dis 122:721–724
Catterall JR, Potasman I, Remington JS (1985) Pneumocystis carinii pneumonia in the patient with AIDS. Chest 88:758–762
Coleman DL, Dodek PM, Luce JM, Golden JA, Gold WM, Murray JF (1983) Diagnostic utility of fiberoptic bronchoscopy in patients with pneumocystis carinii pneumonia and the acquired immune deficiency syndrome. Am Rev Respir Dis 128:795–799
Golden JA, Hollander H, Stulbarg MS, Gamsu G (1986) Bronchoalveolar lavage as the exclusive diagnostic modality for pneumocystis carinii pneumonia. A prospective study among patients with acquired immunodeficiency syndrome. Chest 90:18–22
Reynolds HY (1987) Bronchoalveolar lavage. Am Rev Resp Dis 135:250–263
de Gracia J, Curull V, Vidal R, Riba A, Orriols R, Martin N, Morell F (1988) Diagnostic value of bronchoalveolar lavage in suspected pulmonary tuberculosis. Chest 93:329–332
Pant K, Chawla R, Mann PS, Jaggi OP (1989) Fiberbronchoscopy in smear-negative miliary tuberculosis. Chest 95:1151–1152
Willcox PA, Potgieter PD, Bateman ED, Benatar SR (1986) Rapid diagnosis of sputum-negative miliary tuberculosis using the flexible fibreoptic bronchoscope. Thorax 41:681–684
Chiodini PL, Williams AJ, Barker J, Innes JA (1985) Bronchial lavage and transbronchial lung biopsy in the diagnosis of Legionnaires disease. Thorax 40:154–155
Emanuel D, Peppard J, Stover D, Gold J, Armstrong D, Hammerling U (1986) Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchoalveolar lavage using human and murine monoclonal antibodies. Ann Intern Med 104:476–481
Paradis IL, Grgurich WF, Dummer JS, Dekker A, Dauber JH (1988) Rapid detection of cytomegalovirus pneumonia from lung lavage cells. Am Rev Respir Dis 138:697–702
Credle WF Jr, Smiddy JF, Elliott RC (1974) Complications of fiberoptic bronchoscopy. Am Rev Respir Dis 109:67–72
Suratt PM, Smiddy JF, Gruber B (1976) Deaths and complications associated with fiberoptic bronchoscopy. Chest 69:747–751
Simpson FG, Arnold AG, Purvis A, Belfield PW, Muers MF, Cooke NJ (1986) Postal survey of bronchoscopic practice by physicians in the United Kingdom. Thorax 41:311–317
Pereira W Jr, Kovnat DM, Snider GL (1978) A prospective cooperative study of complications following flexible fiberoptic bronchoscopy. Chest 73:813–816
Albertini R, Harrel JH, Moser KM (1974) Letter: Hypoxemia during fiberoptic bronchoscopy. Chest 65:117–118
Dubrawsky C, Awe RJ, Jenkins DE (1975) The effect of bronchofiberscopic examination on oxygenation status. Chest 67:137–140
Hendy MS, Bateman JR, Stableforth DE (1984) The influence of transbronchial lung biopsy and bronchoalveolar lavage on arterial blood gas changes occurring in patients with diffuse interstitial lung disease. Br J Dis Chest 78:363–368
Payne CB Jr, Goyal PC, Gupta SC (1986) Effects of transoral and transnasal fiberoptic bronchoscopy on oxygenation and cardiac rhythm. Endoscopy 18:1–3
Belen J, Neuhaus A, Markowitz D, Rotman HH (1981) Modification of the effect of fiberoptic bronchoscopy on pulmonary mechanics. Chest 79:516–519
Neuhaus A, Markowitz D, Rotman HH, Weg JG (1978) The effects of fiberoptic bronchoscopy with and without atropine premedication on pulmonary function in humans. Ann Thorac Surg 25:393–398
Shrader DL, Lakshminarayan S (1978) The effect of fiberoptic bronchoscopy on cardiac rhythm. Chest 73:821–824
Lindholm CE, Ollman B, Snyder JV, Millen EG, Grenvik A (1978) Cardiorespiratory effects of flexible fiberoptic bronchoscopy in critically ill patients. Chest 74:362–368
Zavala DC, Godsey K, Bedell GN (1981) The response to atropine sulfate given by aerosol and intramuscular routes to patients undergoing fiberoptic bronchoscopy. Chest 79:512–515
Burman SO (1960) Bronchoscopy and bacteremia. J Thorac Cardiovasc Surg 40:635–639
Pereira W, Kovnat DM, Khan MA, Iacovino JR, Spivack ML, Snider GL (1975) Fever and pneumonia after flexible fiberoptic bronchoscopy. Am Rev Respir Dis 112:59–64
Watts WJ, Green RA (1984) Bacteremia following transbronchial fine needle aspiration (Letter). Chest 85:295
Witte MC, Opal SM, Gilbert JG, Pluss JL, Thomas DA, Olsen JD, Perry ME (1986) Incidence of fever and bacteremia following transbronchial needle aspiration. Chest 89:85–87
Kane RC, Cohen MH, Fossieck BE Jr, Tvardzik AV (1975) Absence of bacteremia after fiberoptic bronchoscopy. Am Rev Respir Dis 111:102–104
Herf SM, Suratt PM, Arora NS (1977) Deaths and complications associated with transbronchial lung biopsy. Am Rev Respir Dis 115:708–711
Zavala DC (1976) Pulmonary hemorrhage in fiberoptic transbronchial biopsy. Chest 70:584–588
Springmeyer SC, Silvestri RC, Sale GE, Peterson DL, Weems CE, Huseby JS, Hudson LD, Thomas ED (1982) The role of transbronchial biopsy for the diagnosis of diffuse pneumonias in immunocompromised marrow transplant recipients. Am Rev Respir Dis 126:763–765
Koerner SK, Sakowitz AJ, Appelman RI, Becker NH, Schoenbaum SW (1975) Transbronchial lung biopsy for the diagnosis of sarcoidosis. N Engl J Med 293:268–270
Joyner LR, Scheinhorn DJ (1975) Transbronchial forceps lung biopsy through the fiberoptic bronchoscope. Diagnosis of diffuse pulmonary disease. Chest 67:532–535
Feldman NT, Pennington JE, Ehrie MG (1977) Transbronchial lung biopsy in the compromised host. JAMA 238:1377–1379
Ellis JH Jr (1975) Transbronchial lung biopsy via the fiberoptic bronchoscope. Experience with 107 consecutive cases and comparison with bronchial brushing. Chest 68:524–532
Puksa S, Hutcheon MA, Hyland RH (1983) Usefulness of transbronchial biopsy in immunosuppressed patients with pulmonary infiltrates. Thorax 38:146–150
Poe RH, Israel RH, Utell MJ, Hall WJ (1979) Probability of a positive transbronchial lung biopsy result in sarcoidosis. Arch Intern Med 139:761–763
Duerschmied H, Wiesner B, Liebetrau G, Haenselt V, Jaeger J, Lenich R (1985) Die Kombination von transbronchialer Lungenbiopsie und broncholveolärer Lavage bei disseminierten Lungenkrankheiten. Z Erkr Atmungsorgane 165:220–227
Cunningham JH, Zavala DC, Corry RJ, Keim LW (1977) Trephine air drill, bronchial brush, and fiberoptic transbronchial lung biopsies in immunosuppressed patients. Am Rev Respir Dis 115:213–220
Andersen HA (1978) Transbronchoscopic lung biopsy for diffuse pulmonary diseases. Results in 939 patients. Chest 73:734–736
Cujnik F (1978) Perbronchiale Lugenbiopsie. Fortschr Med 96:2353–2354
Papin TA, Lynch JP 3d, Weg JG (1985) Transbronchial biopsy in the thrombocytopenic patient. Chest 88:549–552
Poe RH, Utell MJ, Israel RH, Hall WJ, Eshleman JD (1979) Sensitivity and specificity of the nonspecific transbronchial lung biopsy. Am Rev Respir Dis 119:25–31
Burt ME, Flye MW, Webber BL, Wesley RA (1981) Prospective evaluation of aspiration needle, cutting needle, transbronchial and open lung biopsy in patients with pulmonary infiltrates. Ann Thorac Surg 32:146–153
Zellweger JP, Leuenberger PJ (1982) Cytologic and histologic examination of transbronchial lung biopsy. Eur J Respir Dis 63:94–101
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Dierkesmann, R. The diagnostic yield of bronchoscopy. Cardiovasc Intervent Radiol 14, 24–28 (1991). https://doi.org/10.1007/BF02635527
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DOI: https://doi.org/10.1007/BF02635527