Bronchoscopic and cytopathological findings of tracheobronchial involvement in esophageal carcinoma

To evaluate the usefulness of bronchoscopic and cytopathologic examinations for tracheobronchial involvement of esophageal carcinoma, we reviewed 14 cases of esophageal carcinoma suspected of tracheobronchial invasion. Two cases underwent bronchoscopy for postoperative respiratory symptoms, and both revealed endotracheal tumor growth and proved positive at brush cytology and biopsy. Among nine cases submitted to preoperative examination, bronchoscopy showed only protrusion in four cases, and redness with mucosal protrusion in five cases. Two of the latter evidenced cancer cells on brushing specimen, and their prognosis was poor. The remaining three cases underwent bronchoscopy for preoperative severe respiratory symptoms. Tumor growth was noted in two of them, and cytology or biopsy was positive. We conclude that bronchoscopy for tracheobronchial involvement of esophageal carcinoma plays a major role in the diagnosis of extra-esophageal extension. Because of the anatomical situation, biopsy is sometimes difficult. Brush cytology in important in the case of mucosal protrusion and redness.