[Bronchoscopic diagnosis of lung tumours]

The role of diagnostic bronchoscopy in patients with lung tumours is to evaluate the presence, extent and character of endobronchial tumourous changes. Videobronchoscopes and ultrathin bronchoscopes introduced recently into clinical practice make more accurate evaluation of larger areas of the bronchial tree possible. The clinical impact of methods based on the principle of (auto)fluorescence is searched for. From sites affected with the tumour samples are taken for histological or cytological examination which in addition to evidence of a tumourous etiology specify the type of tumour. An integral part of the examination is staging when the extent of the tumour proper and the regional lymph nodes within the framework of the TNM classification is evaluated optically and by aimed sampling. Examination by endobronchial ultrasound makes it possible to assess more accurately the extent of tumourous affection in the bronchial wall or extrabronchially. The task of the brochologist is also to evaluate the possbility of bronchological intervention (laser, brachytherapy, stent etc.) for palliation of symptoms. Virtual bronchoscopy is the arteficial construction of the image of central airways created from CT scans which makes it possible to visualize sections of the central airways which are not accessible by bronchoscopy. Bronchoscopy is a method of fundamental importance for the diagnosis, therapy and control of complications and palliation of symptoms of lung tumours. This method cannot be replaced at the moment by any other method and its importance is apparent from the fact that the spectrum of bronchoscopic examinations in patients with lung tumours is steadily increasing.