P- ISSN 1991-8941 E-ISSN 2706-6703 Journal of University of Anbar for Pure Science (JUAPS) Open Access 2010,(4), (1 ) :04-09 4 Evaluation of laboratory examination of Bronchial Wash Versus Sputum Examination in Diagnosing Lung Diseases Saad M. Mehaidi* Essam M. Abdullah* Belal M. Taha* Suzan Abdul Karim * College of Medicine – Al-anbar University ** Al-Ramadi Technical Hospital . ARTICLE INFO ABSTRACT Received: 12 / 12 /2009 Accepted: 6 / 5 /2010 Available online: 14/6/2012 DOI: 10.37652/juaps.2010.15461 Sputum study and bronchial wash study are considered two of the most common well known classic diagnostic tools in detecting various lung diseases among the wide and continuously expanding diagnostic procedures for detection of lung pathology. Sputum study still play a rule in diagnosis of lung diseases but the sensitivity of the sample is highly depended on the procedure of collection and the co-operation of the patient, the type and the site of lung lesion. Fiber optic bronchoscopy is another option providing both direct visualization of the trachea- bronchial tree and the bronchial wash collected by the fiber optic bronchoscopy provides important information for detection of various lung diseases. the study was conducted in ramadi teaching general hospital. This is a comparison prospective study of 45 consecutive patients whom underwent both sputum collection and bronchoscopy for bronchial wash collection and comparing the results of the patients which showed that among the 45 patients 33 patients had inconclusive or negative sputum studies while 12 patients had positive sputum study in comparison with bronchial wash which give positive results in 41 patients. This study confirms that the sensitivity of bronchial wash is much higher than bronchial wash is much higher than the sputum study in diagnosing lung diseases and the higher sensitivity usually associated with abnormal chest x-ray.the study confirms the importance of these tools for rapid diagnosis of a disease with starting immediate therapy, economic value in reducing time-admission period in the hospital with high necessity to support a staff well trained on bronchoscopy to ensure rapid and accurate diagnoses of chest diseases. Keywords: laboratory examination , Bronchial Wash , Sputum Examination , Lung Diseases. Introduction Endoscopy is a procedure used to visualize the internal organs by passing an instrument through a natural or artificial orifice (1). Bronchoscopy endoscopic procedure provides direct access to the tracheo-bronchial tree and plays an essential role in the diagnosis and treatment of patients with chest problems (2). Fiber-optic bronchoscopy:- are flexible bronchoscopes that composed of fiber optic bundles which provides both illumination and visualization pathways. Small channel with diameter (1-3) mm traverse the fiber optic scope through which suction, cathters, brush and biopsy can be taken for chemical, cytological, bacteriological, viral, protozoal and histopath -logical examination(3,4,5). Diagnostic indication of bronchoscopes(1,5,6,and 7):- * Corresponding author at: College of Medicine – Al-anbar University, Iraq.E-mail address: 1-persistant coughs. 2-hemoptysis. 3-wheeze or bronchial obstruction. 4-abnormal thoracic radiography. 5-suspected bronchogenic carcinoma. 6-airway obstruction. Cytology of normal epithelial cells:- Squamous cells usually oral in origin ,see mixture of intermediate and anucleus embedded in uniformely thin cynophilic cytoplasm. superficial cells have pycnotic nuclei with orangeophilic cytoplasm . Ciliated bronchial columinar cells characterized by columonar or prismatic shape ending in a tail,the nucleus is oriented toward the tail and show finely granular chromatin with one or more nucleoli. Macrophage cells recognized by eccentrics position of the nucleus with abundant foamy cytoplasm.