In suspected central bronchogenic carcinoma, which diagnostic approach yields tissue?

• A. Pleural Fluid Analysis
• B. Bronchoscopy
• C. Mediastinoscopy
• D. Transthoracic Needle Biopsy

Answer: (B)

Direct access to an endobronchial tumor is what you need to obtain meaningful tissue, and bronchoscopy provides that access. Central bronchogenic carcinomas grow within the tracheobronchial tree, so visualizing the lesion and taking a biopsy directly from it gives the most reliable tissue for histology. Bronchoscopy can also collect brushings or washings to supplement biopsy with cytology, increasing diagnostic yield.

Other options have roles but aren’t as effective for obtaining tissue from a central lesion. Pleural fluid analysis depends on the presence of an effusion and may show malignant cells without sampling the tumor itself. Mediastinoscopy targets mediastinal nodes rather than the primary endobronchial tumor, and transthoracic needle biopsy is better suited for peripheral lesions and carries pneumothorax risk. Therefore, bronchoscopy is the best choice for obtaining tissue in suspected central bronchogenic carcinoma.