Bronchoscopy and bone marrow examinations. An efficient strategy to establish the diagnosis of small cell carcinoma of the lung

The utility of various diagnostic procedures, including fiberoptic bronchoscopy and bone marrow aspirate/biopsy for small cell carcinoma, was examined in 150 patients. From a chart review of the first 100 patients, 55 required an invasive procedure such as mediastinoscopy or thoracotomy to establish the tissue diagnosis. In 50 consecutive prospective patients, only four required an invasive procedure for tissue confirmation. Eighteen of the 50 prospective patients had positive iliac crest bone marrow aspirates or biopsies diagnostic for small cell carcinoma. Fiberoptic bronchoscopy was nondiagnostic in 15 prospective patients, but the bone marrow examination was diagnostic in 12 of this subgroup. The combination of fiberoptic bronchoscopy and bone marrow examination in patients with centrally located small cell carcinoma greatly reduced the need for more expensive and invasive diagnostic procedures.