Ketepatan Diagnosis Sitopatologi Bronchial Washing dan Brushing Secara Tunggal dan Kombinasi dalam Mendiagnosis Adenocarcinoma Of The Lung Dan Squamous Cell Carcinoma Of The Lung Berdasarkan Konfirmasi Diagnosis Histopatologi di Unit Patologi Anatomik Rumah Sakit Pendidikan Prof. Dr. Chairuddin Panusunan Lubis Medan Periode Januari 2023 – Juni 2024

Abstract

Objective: The Diagnostic Accuracy of Bronchial Washing and Brushing Cytopathology, Single and Combined, in Diagnosing adenocarcinoma of the lung and Squamous cell carcinoma of the lung Based on Histopathological Confirmation In the Anatomic Pathology Unit of Prof. Dr. Chairuddin Panusunan Lubis Teaching Hospital, Medan January 2023 – June 2024. Methods: This was a descriptive study with a cross-sectional design. Data were collected retrospectively from medical records of patients who underwent BAL and/or BB procedures, followed by cytopathological examination and histopathological confirmation using Hematoxylin & Eosin staining. Data analysis was performed using descriptive statistics with SPSS software. Results: Out of a total 38 specimens, a diagnosis of adenocarcinoma of the lung was found in 21 patients (55.3%) and squamous cell carcinoma in 17 patients (44.7%). In bronchoalveolar lavage (BAL), lung adenocarcinoma exhibited individual cells or small clusters with cytoplasmic vacuolation containing mucin and acinar/papillary patterns, whereas squamous cell carcinoma (SCC) showed large cells with eosinophilic cytoplasm, pleomorphic nuclei, and keratin pearls. In bronchial brushing (BB), adenocarcinoma appeared as cells arranged in acinar or papillary structures with prominent nucleoli, while SCC was observed as dense clusters of eosinophilic cells with keratinization. The sensitivity of BAL reached 95.2% for adenocarcinoma and 47.1% for SCC, whereas BB demonstrated a sensitivity of 76.2% for adenocarcinoma and 94.1% for SCC. The combination of BAL and BB increased the diagnostic sensitivity to 95.2% for adenocarcinoma and 94.1% for SCC. Conclusion: Bronchoalveolar lavage (BAL) and bronchial brushing (BB) demonstrate distinct cytomorphological features in diagnosing adenocarcinoma and squamous cell carcinoma of the lung. BB offers higher sensitivity, while combining both techniques significantly improves diagnostic accuracy for lung cancer.

Keywords: Cytomorphology, BAL, bronchial brushing, lung adenocarcinoma, lung squamous cell carcinoma.