Diagnostic, Morphologic, and Histopathologic Correlates in Bronchogenic Carcinoma: Discussion (1)
This study has diverse results but has one message of particular interest. The number of biopsy specimens needed to obtain an optimal diagnostic yield is an important consideration in applying fiberoptic bronchoscopy. Although recommendations exist in the literature for performing up to six forceps biopsies, the optimal number of specimens has not been defined. In 1982, Popovich et al found a diagnostic yield of 92 percent, after six biopsies of each endobronchial lesion and 40 histologic sections of each specimen. flovent inhaler
In contradistinction, Shure et al could correctly diagnose by the third biopsy all of the carcinomas of their series. This was obtained by examining only subjects with tumor-like endobronchial abnormalities and no more than nine tissue sections. Various explanations were suggested to account for this difference in results, including the size and type of forceps. Our data indicate that the difference might be due to another cause, ie, to the type of endobronchial lesion selected for the study. The more successful investigators, indeed, had limited their analysis to those abnormalities which we have found to be more fruitfully biopsied using the forceps instrument.