Bronchoscopic biopsy and brushing with fluoroscopic guidance in nodular metastatic lung cancer

Forty-five patients with endoscopically invisible metastatic cancer of the lung underwent flexible fiberoptic bronchoscopic examination under fluoroscopic guidance, with biopsy specimens and brushing being obtained. In all patients, the lesions were single or multiple nodules. A diagnostic specimen was obtained by biopsy or brushing (or both) in 53 percent, by biopsy alone in 47 percent, and by brushing alone in 6 percent. Brushings were diagnostic in three patients when the biopsy specimen was normal. Washings did not add to the overall diagnostic value of the procedure. In 36 patients, the lesions were 2 cm or greater, yielding diagnostic specimens in 23 patients (64 percent).