Bronchogenic carcinoma presenting as an endobronchial mass

Area of Science:

• Pulmonology
• Oncology
• Pathology

Background:

• Accurate diagnosis of endobronchial mass lesions is crucial for effective lung cancer treatment.
• Determining the optimal number of biopsies balances diagnostic yield with procedural risks like bleeding.

Purpose of the Study:

• To establish the ideal number of biopsy specimens required for diagnosing bronchogenic carcinoma from endobronchial mass lesions.
• To evaluate the diagnostic yield and statistical significance of successive biopsies.

Main Methods:

• Eighteen endobronchial mass lesions underwent five biopsies each.
• Biopsy specimens were processed individually and analyzed blindly to assess diagnostic yield.
• Statistical analysis, including Cochran Q test, evaluated the significance of negative diagnoses and biopsy dependence.

Main Results:

• All tumors were diagnosed within the first three biopsy samples.
• The probability of diagnosing malignancy was 88.9% after one biopsy, 98.77% after two, and 99.86% after three.
• No significant difference was found in negative diagnoses across the five biopsies, indicating diminishing returns.

Conclusions:

• Performing three biopsies of endobronchial mass lesions provides an optimal diagnostic yield for bronchogenic carcinoma.
• Increasing the number of biopsies beyond three does not substantially improve diagnostic accuracy and may increase bleeding risk.