Sequential brush biopsy and conventional biopsy: direct comparison of diagnostic sensitivity in lung malignancy.

One hundred and sixteen patients with suspected lung malignancy who were referred for bronchoscopy were examined using both the flexible fibreoptic bronchoscope and the rigid bronchoscope. Both instruments were used sequentially under the same general anaesthetic. Brush biopsies were obtained through the fibreoptic bronchoscope and conventional biopsies, for histological examination, through the rigid bronchoscope. Both specimens were taken from the same area. Eighty-two per cent of those in whom there was a final clinical diagnosis of malignancy were found to have abnormal cytology via the fibreoptic bronchoscope, while abnormal histology was found in 50% by means of the rigid bronchoscope. For those in whom malignancy was confirmed, 16.9% showed disagreement between the two methods in cell typing. Brush biopsy through the flexible fibreoptic bronchoscope under general anaesthesia is confirmed as a sensitive method for diagnosing lung malignancy.