Objectives: Immunohistochemistry (IHC) is an important component of lung cancer diagnosis and management, although performance can be limited due to tissue availability. We describe a novel technique for processing brush-tip washings (BTW) and evaluate the feasibility of IHC testing on these samples. Study Design: All patients who had cell blocks (CB) created from BTW following bronchoscopic investigation of peripheral lung lesions were included. CB were assessed for adequate material before undergoing IHC staining. Results: 75 patients were included in the study, with bronchoscopic diagnosis of malignancy achieved in 77%. Sixty-seven samples (89%) had sufficient cells for diagnosis on CB and 56 of these (84%) proved amenable to IHC. CB created from BTW were the sole specimens available for IHC subtyping in 7 patients (9%). Conclusions: CB are easily created from BTW and are a simple method for increasing the diagnostic utility of bronchoscopic specimens without increasing the risk or duration of bronchoscopy. IHC can be easily performed in a high proportion of cases, increasing the likelihood of accurate sub-typing of tumours following diagnostic bronchoscopy.

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