Lung cancer is most common and serious health problem worldwide. All over world it accounts for 13% of all new cancer cases and 19% of cancer related deaths [1].  Majority of patients having lung cancer had direct exposure to smoking [2]. It also remains the most common malignancy in men worldwide (1.2 million, 16.7% of total). In females, incidence rates are lower than that of males, but its incidence and mortality are rising [3]. Occupational exposures and air pollution approximately accounts for 2% to 9% of lung cancers. Approximately 85% patients with lung cancer are symptomatic at presentation. In remaining patients, lung cancer is diagnosed by various radiological methods initiated for an unrelated health problem and histopathological examination [4]. 

The clinical features of carcinoma lung result from the local growth and regional growth of the tumor as well as lymphatic invasion, haematogenous distant metastatic spread and remote para-neoplastic effects from tumour products or immune cross-reaction with tumour antigens [5]. More interest has been developed in the histological characterisation of lung cancer in recent years in view of newer histology guided therapeutic modalities and genomic classification of lung carcinoma [6]. The present study aimed at histopathological spectrum of endobronchial biopsies.

This record based cross sectional study was carried out in the department of Pathology, Indira Gandhi Medical College, Shimla. The data of all bronchial biopsy specimens was collected from record register of January to December 2018. Data was collected using a structured clinical Performa which included various sociodemographic and clinical variables. Data was analysed using Epi Info software version 7.2.2. Data was presented as frequencies, percentages.

We had collected information regarding 198 bronchial biopsy specimens received in the department of pathology during study period.

Most of the patients were in age group of >=60 years (66.2%) with mean age 62 years. Males were 139 with male to female ratio was 2.4:1. Right lung was involved (49.7%) more than left (33.1%) followed by hilum (16%) and bilateral lungs (1.1%). Majority of lesions were malignant (80.3%), followed by benign (16.2%) and rest were inconclusive due to inadequate biopsy tissue.

Table 1: Description of different sociodemographic and clinical variables of Bronchial biopsy specimens

On histopathological examination, non-small cell carcinoma was 109 (55%) out of which squamous cell carcinoma was found to be more common (29.3%) followed by Adenocarcinoma (23.2%) and others. Small cell carcinoma constituted 25.8%. Among benign lesions, granulomatous lesions were more common (5.05%) than pneumonia and fungal infections.

Bronchogenic carcinoma is the most common malignancy all over the world in terms of both incidence and mortality. It also remains the most common malignancy in men worldwide (1.2 million, 16.7% of total) [4]. Majority of patients having lung cancer had direct exposure to smoking. Squamous cell carcinomas and small cell carcinomas shows significant association with smoking [7].

In our study, mean age of presentation was 62 years which is comparable to other studies [8,9]. Of 198 patients included in the study, 139 patients were male and 59 patients were females. The ratio of male: female was 2.4:1. This ratio is lower as compared to other Indian studies conducted by Pujari et al. [9] (ratio – 4.12:1), Dhandapani et al. [10] (ratio – 3.9:1).

Right lung was most commonly involved 87 (49.71%) followed by left lung involved in 58 (33.14%) cases and hilar region 28(16%) which is similar to Sarfraz et al. [11] but hilar region is more common site than left lung in their study. Majority of lesions were malignant (80.3%), followed by benign (16.2%) that can be corelated with Wani et al. [12].

Squamous cell carcinoma was found to be the most common type of carcinoma in 58 (29.3%) patients followed by small cell carcinoma 51 (25.8%) and Adenocarcinoma (23.2%) which is in concordance with [11, 12] However, Thakkar et al. [8] reported more cases of adenocarcinoma.

In the present study done on 198 bronchial biopsy specimens out of which malignant lesions were more common than benign. Majority were squamous cell carcinoma followed by small cell carcinoma with predominantly right lung involvement. Mean age was 62 years and male to female ratio was 2.4:1. Most of the patients were elderly with narrowed gender gap, smoking being the most probable cause. So early detection and treatment should be emphasized along with imparting awareness on harmful effects of smoking.

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