Diagnostic accuracy of Lung Biopsy and Bronchoalveolar Lavage (BAL) in Lung Malignancy

Abstract

Objective: The study was designed to correlate histopathology of lung biopsy and bronchoalveolar lavage (BAL) cytology in the diagnosis of lung malignancy and to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of bronchoalveolar lavage cytology using histopathology of lung biopsy as gold standard. Study Design: The retrospective and prospective study was conducted at Pathology Department of Tertiary care centre from October 2017 to October 2019, to investigate a total of 54 patients who were clinically/radiologically suspected of lung malignancy and who underwent both bronchial biopsy and bronchoalveolar lavage. Results: On histopathological examination of biopsies, 29 cases (53.7%) were malignant whereas on cytological examination of BAL 19 cases (35.18%) were correctly diagnosed as malignant and 4 cases (7.4%) as suspicious/atypical. The sensitivity, specificity, PPV, NPV and overall diagnostic accuracy of BAL was 79.3%, 100%, 100%, 86.2% and 88.9% respectively. Conclusion: It was observed that BAL cytology is sensitive and specific for the diagnosis of lung cancer. Cytopathological examination complements histopathology in both diagnosing and typing of lung tumours.