Use of the flexible fibre-optic bronchoscope in the diagnosis of lung carcinoma.

Bronchoscopy carried out in 367 patients because of a chest radiograph suggestive of lung carcinoma confirmed this diagnosis in 194 cases and excluded it in 173. The diagnosis of carcinoma was made by fibre-optic bronchoscopy in 141 cases (73%), by examination of biopsy specimens and bronchial brushings in 125, and by visualization and follow-up in 16. Visible tumours accounted for 40% of the malignant lesions and 79% of these were diagnosed on examination of biopsy specimens or brushings, compared with 55% of non-visible tumours. Of the tumours 131 were radiographically peripheral, and 60% of these were diagnosed with the fibre-optic bronchoscope. The diagnostic yield in the 63 proximal tumours was 98%.