Diagnostic Yield of Fiber Optic Bronchoscopy and CECT Thorax in Patients of Haemoptysis with Normal Chest X-Ray

  • Dr Abinash Agarwala R.M.O. cum C.T. Chest ,Medinipore Medical College& Hospital, West Bengal, India
  • Dr. Sumitra Basuthakur Professor & H.O.D, Chest & Respiratory Medicine, Calcutta Medical College, Kolkata, India
  • Dr. Shelley Shamim Associate Professor, Calcutta National Medical College & Hospital, Kolkata, India
  • Dr. Kaushik Saha Assistant Professor, B.M.C &H ,West Bengal, India
  • Dr. Sujit Bhattacharya Assistant. Professor, N.R.S.M.C.&H, Kolkata, India
  • Dr. Amitabha Sengupta Associate Professor, N.R.S.M.C.&H, Kolkata, India
DOI: https://doi.org/10.17511/ijmrr.2015.i1.10
Keywords: Computed Tomography Thorax, Bronchoscopy, Hemoptysis, Radiography, Thoracic

Abstract

Introduction: Contrast enhanced computed tomography (CECT) thorax & Fibre Optic Bronchoscopy (FOB) are main investigations in patients of hemoptysis with normal chest X-ray. But there are limited data on their diagnostic yield especially from South East Asia.

Methods: An observational study on 60 patients with hemoptysis with normal chest X -ray was conducted from April 2012 to April 2014. CECT thorax and FOB were done in all of them.

Results: Out of 60 patients 38 (63.3%) were male with even age distribution. Yield of CECT was 40% (24 patients) and main diagnosis were bronchiectesis (25%) and tuberculosis (11.6%). Diagnostic yield of FOB was 47% (28 patients) with predominant diagnosis of tuberculosis (18.33%), bronchitis (18.33%) and bronchogenic carcinoma (6.66%). Overall diagnostic yield was 76.6% (46 cases). Bronchogenic carcinoma cases were all male smokers and 3 of them were more than 40 years old.

Conclusion: CECT thorax and FOB are complimentary to each other in evaluation of hemoptysis with normal chest x-ray. Bronchogenic carcinoma and tuberculosis cases require specific treatment and they were diagnosed in confirm way only by FOB. So, FOB have advantage over CT scan, especially among patients with increased risk of bronchogenic carcinoma (male-smokers with age > 40 years).

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References

1. Weaver LJ, Solliday N, Cugell DW. Selection of patients with haemoptysis for fiber optic bronchoscopy. Chest. 1979; 76(1):7-10. [PubMed]

2. Poe RH, Israel RH, Marin MG, , Ortiz CR, Dale RC, Wahl GW et al. Utility of fibreoptic bronchoscopy in patients with hemoptysis and a nonlocalizing chest roentgenogram. Chest. 1988;93(1):70–5. [PubMed]

3. Haponik EF, Britt EJ, Smith PL, Bleecker ER. Computed chest tomography in the evaluation of haemoptysis . Impact on diagnosis and treatment. Chest 1987; 91(1): 80-5. [PubMed]

4. Weinberger SE. Principles of Pulmonary Medicine. 3rd edition.Philadelphia: Saunders; 1988. [PubMed]

5. Millar AB, Boothroyd AE, Edwards D, Hetzel MR. Role of computed tomography(CT) in the investigation of unexplained haemoptysis. Respir Med 1992;86(1):39-44. [PubMed]

6. Magu S, Malhotra R, Gupta KB, Mishra DS. Role of computed tomography in patients with haemoptysis and a normal chest skiagram. Indian J Chest Dis Allied Sci. 2000 Apr-June;42(2):101-4. [PubMed]

7. Sood R, Mukhopadhyaya S. Approach to a patient with haemoptysis and a normal chest X-ray. J Indian Acad Clin Med. 2002;3(1):14–22. [PubMed]

8. Jones R, Latinovic R, Charlton J, Gulliford MC. Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database. BMJ.2007;334(7602):1040.doi:10.1136/bmj.39171. 637106. [PubMed]

9. Haro Estarriol M, Vizcaya Sanchez M, Jimenez Lopez J,Tornero Molina A. Etiology of hemoptysis: prospective analysis of 752 cases. Rev ClinEsp 2001;201(12):696–700. [PubMed]

10. Haro M, Jiménez J, Tornero A, Vizcaya M, Tirado R, Cros T. Usefulness of computerized tomography and bronchoscopy in patients with hemoptysis. Analysis of 482 cases.An Med Interna 2002;19(2):59–65. [PubMed]

11. Barrett RJ, Tuttle WM. A study of essential haemoptysis J Thorac Cardiovasc Surg. 1960 Oct;40:468-74.

12. Snider GL. When not to use bronchoscope for haemoptysis (Editorial). Chest. 1979 Jul;76(1):1-2. [PubMed]

13. Zavala DC. Diagnostic fiberoptic bronchoscopy: techniques and results of biopsy in 600 patients. Chest. 1975 Jul;68(1):12-9. [PubMed]

14. Jindal SK, Gilhorta R, Behera D. Fiberoptic examination in patients with hemoptysis and normal chest X-ray. J Assoc Physicians India. 1990 Aug;38(8):548-9. [PubMed]

15. Sharma SK, Dey AB, Pande JN, Verma K. Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms. Indian J Chest Dis Allied Sci. 1991 Jan-Mar;33(1):15-8.

16. Suri JC, Goel A, Singla R. Cryptogenic haemoptysis: Role of fiberoptic bronchoscopy. Indian J Chest Dis Allied Sci. 1990 Jul-Sep;32(3):149-52.

17. Jackson CV, Savage PJ, Quinn DL. Role of fiberoptic bronchoscopy in patients with haemoptysis and a normal chest roentgenogram. Chest. 1985 Feb;87(2):142-4. [PubMed]

18. Lederle FA, Nichol KL, Parenti CM. Bronchoscopy to evaluate haemoptysis in older men with non-suspicious chest roentgenograms. Chest. 1989 May;95(5):1043-7. [PubMed]

19. Zavala DC. Diagnostic fiberoptic bronchoscopy: techniques and results of biopsy in 600 patients. Chest. 1975 Jul;68(1):12-9. [PubMed]

20. Heimer D, Bar-Ziv J, Scharf SM. Fiberoptic bronchoscopy in patient with haemoptysis and non-localizing chest roentgenogram. Arch Intern Med. 1985 Aug;145(8):1427-8. [PubMed]

21. Heaton RW. Should patients with haemoptysis and a normal chest x ray be bronchoscoped? Postgrad Med J. 1987 Nov;63(745):947-9.
CITATION
DOI: 10.17511/ijmrr.2015.i1.10
Published: 2015-02-28
How to Cite
1.
Agarwala A, Basuthakur S, Shamim S, Saha K, Bhattacharya S, Sengupta A. Diagnostic Yield of Fiber Optic Bronchoscopy and CECT Thorax in Patients of Haemoptysis with Normal Chest X-Ray. Int J Med Res Rev [Internet]. 2015Feb.28 [cited 2024Nov.8];3(1):57-2. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/186
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Vol 3 No 1 (2015): Jan-Feb
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Original Article