Comparison of Diagnostic Yield of Various Bronchoscopic Modalities in Diagnosis of Patients having Central Lung Mass in a Tertiary Care Hospital - An Observational Study

Background: Lung cancer remains a major cause of morbidity and mortality worldwide. Early diagnosis is critical for effective treatment. This study evaluates the demographic profile, clinical presentation, radiological features, bronchoscopic findings, and diagnostic efficacy of various bronchoscopic sampling techniques in detecting central lung mass. Material and Methods: A cross-sectional study was conducted in a single tertiary care center on 41 patients diagnosed with central lung masses based on clinical evaluation, radiological imaging, and bronchoscopic assessment. The bronchoscopic techniques included endobronchial biopsy, bronchial wash cytology, brushing cytology, and cell block preparation. The diagnostic yield of each procedure was assessed and compared using standard performance metrics, including sensitivity, specificity, positive and negative predictive values, overall diagnostic accuracy, and receiver operating characteristic (ROC) curves. Results: Most patients were aged 61–70 years (mean: 66.02 ± 9.95), with males comprising 65.85%. Common symptoms included dyspnea (82.9%) and cough (75.6%). Radiologically, right lung masses were most common. The right upper lobe mass lesion was the most frequent CT finding (43.9%), and mediastinal lymphadenopathy was present in 63.4%. Endobronchial biopsy had the highest sensitivity (95.1%). Bronchial brushing cytology showed excellent diagnostic accuracy (74.4%) and highest AUC (0.875), followed by cell block (AUC 0.833). Bronchial wash cytology had low sensitivity (37.8%) but perfect specificity. Conclusion: Endobronchial biopsy remains the diagnostic gold standard, while brushing cytology and cell block provide high diagnostic yields and can complement biopsy, especially when tissue sampling is limited. A multimodal bronchoscopic approach enhances diagnostic accuracy in central lung mass evaluation.