SESSION TITLE: Bronchoscopy and Interventional Procedures Posters
SESSION TYPE: Poster Presentations
PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM
PURPOSE: Fiber-optic bronchoscopy is an invasive procedure performed to identify possible endobronchial lesions. Diabetic patients often present with non-resolving pneumonia and collapse, many of whom are elderly and smoker; thus always giving rise to the suspicion of malignancy.
METHODS: It was an observational study performed from March 2010 to March 2013 in the Department of Internal Medicine & Pulmonology of BIRDEM General Hospital, Dhaka, Bangladesh; a 500 bedded tertiary care hospital dealing mostly with diabetic patients. A total of 160 diabetic patients were taken in the study.
RESULTS: Out of 160 patients 126 (78.75%) were male, 34 (21.25%) were female. Mean age of the patients was - 57.2 ±10.8 years. Among the indications of bronchoscopy - collapse 38 (23.8%), non-resolving consolidation 55 (34.4%), mass lesion 38 (23.8%), hemoptysis 10 (6.3%), others 19 (11.8%). Findings in the bronchoscopy were - Mitotic lesion 56 (35.0%), Inflammatory lesion 50 (31.3%), normal finding in 54 (33.8%). Among 56 (100%) cases of mitotic lesion, bronchial biopsy was taken in 48 (85.7%) cases. In 8 (14.3%) cases biopsy was not taken as the nature of the lesion was very much suggestive of malignancy with carina involvement and the risk of bleeding was high. In the 48 (100%) cases where biopsy was taken, histopathology report was - squamous cell carcinoma 18 (37.5%), large cell carcinoma 11 (22.9%), Adenocarcinoma 7 (14.6%), small cell carcinoma 5 (10.4%), inflammatory finding in 4 (8.3%) and normal finding in 3 (6.3%). In correlation of indication with findings in bronchoscopy - among 38 (100%) cases of collapse, mitotic lesion was found in 24 (63.2% ) cases, among 55 (100%) cases of non-resolving consolidation, mitotic lesion in 18 (32.5% ), inflammation in 23 (41.8%) and normal in 14 ( 25.5%) cases. [p = .034]. Among 56 (100%) cases of mitotic lesion carina was involved in 33 (58.9%) cases. [p = .000]
CONCLUSIONS: Bronchoscopy is a very sensitive method to detect any endobronchial lesion in suspected cases of collapse or non-resolving pneumonia. But careful case selection is important.
CLINICAL IMPLICATIONS: Bronchoscopy can be the choice of investigation in non-resolving pneumonia.
DISCLOSURE: The following authors have nothing to disclose: Jamal Ahmed
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