A bronchofibroscopic analysis of the bronchial mucosa using a dye-scattering method for the detection of bronchial lesions.

A study was undertaken to evaluate the usefulness of a dye-scattering method for the analysis of bronchial lesions. After methylene blue was introduced through a cannula, the bronchial staining intensities seen by bronchofibroscopy were later compared with the histologic findings in 74 biopsied specimens of lesions taken from 20 patients with lung cancer and from 6 patients with bronchiectasis, 2 with a rheumatoid lung, and 2 with sarcoidosis. It was found that 86% (25 of 29) of the specimens that stained positively were malignant. Further, 4 specimens that manifested a false positive response to staining were either too small to be inspected histologically or showed necrosis. Of 27 specimens that were negative to staining, 89% (24 of 27) were revealed to be nonmalignant lesions. In this latter group the response of 3 specimens was false negative on histologic inspection, 2 showing cancer cells without surface infiltration. We thus conclude that this dye-scattering method is of great use in enabling the differentiation of nonmalignant mucosa from neoplastic lesions and the preoperative determination of the stage of a tumor.