Source: Annual Congress 2002 - Thoracic oncology: clinical management
Disease area: Thoracic oncology

Abstract

Nuclear cellular atypia is a common finding on cytological examination of bronchial washings from patients suspected of having bronchogenic carcinoma. The sigificance of atypia is uncertain, as is the follow-up that should be offered to such patients. The aim of this study was to determine the prevalence of bronchogenic carcinoma on long-term follow-up of these patients. The cytology reports of all patients who underwent bronchoscopy for suspected bronchogenic carcinoma at our institution during the year 1996 were retrospectively reviewed. Patients who had bronchial washings showing atypia but no definite malignant cells were identified. Chest x-ray and bronchoscopy reports were reviewed and were classified as [dsquote]normal[dsquote] or [dsquote]abnormal[dsquote]. Follow-up data regarding the diagnosis was obtained during 2000-2001 by reviewing patients' medical records, contacting their family doctors and reviewing death certificates.
688 patients underwent bronchoscopy. Of these, 206 were identified with atypical cytology not diagnostic of malignancy. Data was complete in 178 patients. Of this cohort 93 (52%) had a diagnosis of malignancy at follow-up. Of those 93 patients with lung cancer 90 (97%) had an abnormal chest x-ray and 64 (69%) had an abnormal bronchoscopy. No patient who was subsequently diagnosed as having bronchogenic carcinoma had both a normal chest x-ray and a normal bronchoscopy. Of the 93 patients with a follow-up diagnosis of malignancy, 28 (30%) were reported as having [dsquote]atypia[dsquote] while the remaining 65 (70%) had [dsquote]atypia suggestive of malignancy[dsquote].The presence of atypia on bronchial washings is associated with a high risk of bronchogenic carcinoma. In the presence of both a normal chest x-ray and a normal bronchoscopy patients with atypia are unlikely to have a subsequent diagnosis of lung cancer.

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Citations should be made in the following way:
C. M. O'Kane, D. F. McAuley, H. Elliot, J. MacMahon (Belfast, United Kingdom). Cellular atypia in bronchial washings and risk of bronchogenic carcinoma. Eur Respir J 2002; 20: Suppl. 38, 1180

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