Fluorescence Bronchoscopy

Abstract

A new method of fluorescence bronchoscopy is presented which uses a standard light source and a special filter combination to permit the carrying out of fluorescence bronchoscopy with a surface marking method by means of inhaling a fluorescein solution. Normal mucous membrane, or mucous membrane with no histological change other than inflammation, which is cleansed by ciliary activity, does not usually fluoresce for a period longer than about two hours after the inhalation. There were, it is true, 13 false positive fluorescences out of 52 fluorescing areas in the mucous membrane. Correctly recorded were 39 cases of positive, ie, visible tumors, metaplasias, accumulation of mucous glands in the epithelium, and mucous membrane which had undergone a neoplastic change in the sense of a lymphangitis carcinomatosa or a mucous membrane carcinosis; these all caused fluorescence. The false negative results amounted to only two nonfluorescing tumors and one metaplasia. These diagnoses arise from the first 100 patients examined by this method. The fact must be especially emphasized that out of the 58 carcinoma cases, there were 7 where neoplastic changes in the mucous membrane were diagnosed by the fluorescence technique, although they had not been recognized macroscopically either by the naked eye or by the Hopkins optical technique.