Diagnoses of specimens collected through flexible bronchoscopy patients at Muhimbili National Hospital January 2013 to November 2017

Abstract

Background: Flexible bronchoscopy is the technique of visualizing the respiratory airway mucosa from the oropharynx to third generation branching. It is useful in the diagnosis of lung malignancies, lung infections, inflammatory conditions and interstitial lung diseases. It is more than a decade since flexible bronchoscopy was first used at Muhimbili National Hospital in routine diagnosis of pulmonary conditions. Despite its use for several years the diagnoses made have not been structurally organized and studied Objective: The study aimed at describing diagnoses of all specimens collected from patients who underwent bronchoscopy at MNH in the past five years from January 2013 to November 2017. Methodology: A retrospective hospital based cross sectional study was conducted among 451 patients and 360 patents had sample collected for analysis. Data collected included demographic and clinical variables. Descriptive statistics were used to summarize the study findings Results: The number of flexible bronchoscopy increased from 57 cases in 2013 to 180 cases in 2017, a more than threefold increase. Bronchoscopic samples studied included lung biopsies which accounted to 48.3% (174/360) and fluid samples (bronchioalveolar lavage and bronchial washings) which accounted to 80.8% (291/360). Adenocarcinoma was the most common lung cancer among all lung histological subtypes accounting to 33.9% (59/174). Generally, 64.3% (112/174) of all lung biopsies were malignant. Of 76 fluid sample sent for bacterial culture and sensitivity, 11/76 (11.8%) were culture positive, 49/76 (64.5%) did not grow any bacteria, 18/76 (23.7%) isolated normal flora. A total of 6 (10.7%) out of 56 samples which were sent for M.tuberculosis screening through GeneXpert MTB/RIF technology tested positive for M.tuberculosis.

Conclusion: Lung tumor was the leading indication for bronchoscopy. Adenocarcinoma was the most common malignancy among others. Bacterial infections were among the reported findiples