Bronchoscopy

Bronchoscopy is a test that allows a doctor to view the airways (bronchi) with the use of a thin, lighted tube containing a camera. The tube used in bronchoscopy may be flexible or rigid. The flexible scope is most often used. The rigid scope is a straight tube and is only used to view the larger airways. Bronchoscopy, also called fiberoptic bronchoscopy, is used to diagnose and sometimes treat lung conditions. If lung cancer is suspected, bronchoscopy can provide a way for the doctor to view the tumor, assess the extent of the airway obstruction (blockage), and collect a tissue sample for analysis. Bronchoscopy is most often used for diagnosing lung cancer when the suspicious lesion is centrally located, rather than those that are in the periphery, or distant regions of the lungs.1-3

In addition to being used for diagnosing lung cancer, bronchoscopy is also used to examine and potentially diagnose other lung problems, including:

  • Airway blockage or obstruction, including with a foreign object
  • Narrowed airways (strictures)
  • Inflammation and infections like tuberculosis (TB), pneumonia, and fungal infections
  • Interstitial pulmonary disease
  • Causes of persistent cough
  • Causes of coughing up blood
  • Spots seen on chest x-rays
  • Vocal cord paralysis 3

Bronchoscopy can be used to treat a lung or airway problem, such as:

  • Removing a foreign object, fluid, or mucus plugs from the airways
  • Widening an airway that is blocked or narrowed
  • Draining an abscess
  • Treating a cancerous (malignant) tumor using laser therapy or radiation treatment
  • Washing out an airway
  • Controlling bleeding in the bronchi 1,3

What to Expect

Patients are often advised not to eat or drink anything for 6-12 hours prior to having a bronchoscopy. Additional instructions are provided by the doctor and may include stopping the use of some medications, such as aspirin, ibuprofen or other drugs that may increase bleeding risk. Usually, the test is done as an outpatient procedure, meaning the patient does not need to stay in the hospital overnight.1

The patient is given anesthetic to relax and numb the throat muscles. The tube-like instrument, the bronchoscope, is placed through the nose or mouth and guided down into the airways of the lungs. The camera at the end of the tube displays images back to a video screen.1,4

Possible Side Effects

Bronchoscopy is generally a safe procedure. After the anesthetic wears off, the patient may experience a scratchy throat for several days. Serious complications are uncommon (less than 5% of patients), such as an air leak or serious bleeding. Possible side effects from a bronchoscopy include reduced oxygen (generally mild and expected to return to normal), lung leak or collapse, bleeding from biopsy sites, infection, arrhythmias (abnormal cardiac rhythms), difficulty breathing, fever, or a heart attack in people with existing heart disease.1,4

Other Tests Used to Diagnose Lung Cancer

Bronchoscopy is one testing procedure that may be used during the diagnosis process of lung cancer. Other tests that may be used include chest x-ray, CT (computed tomography) scans, PET (positron emission tomography) scans, laboratory tests, thoracentesis, needle biopsy, sputum cytology, thoracoscopy, and pulmonary function testing.

Written by: Emily Downward | Last reviewed: January 2017.
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