Medical bronchoscopy

With the introduction of the flexible fiberoptic bronchoscope, pathologic, cytologic and bacteriologic specimens are readily obtained from areas of the lung previously inaccessible to the endoscopist. Most authors employing this versatile instrument have stressed its value in the diagnosis of carcinoma of the lung, and only a few have emphasized its impact on the practice of medical pulmonary disease. Of 500 consecutive bronchoscopies, 345 were performed for diseases other than carcinoma. The diagnosis and percentage established by flexible bronchoscopy and ancillary procedures are given for diffuse lung disease, opportunistic infections, hemoptysis and tuberculosis. In addition, flexible bronchoscopy was an aid in the diagnosis and/or treatment of pneumonia, atelectasis, and in 28 patients with clinically indeterminate lesions, which proved to be carcinoma. The flexible fiberoptic bronchoscope should be routinely employed by medical pulmonary services and should, except in rare instances, obviate the need for therapeutic trials and 'watchful waiting'.