Abstract
Fiber-optic bronchoscopy is considered an important procedure in interstitial lung diseases (ILD) since it can lead to or discard a diagnosis in many cases. During the last years, the application of thoracic high-resolution computed tomography (HRCT) to ILD evaluation has enhanced the diagnostic approach, but cytological or histological study is often needed to make a confident ILD diagnosis. Frequently, bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) play a significant role in making an accurate diagnosis of specific forms of ILD. However, the standardization of TBLB and BAL protocols, as well as the correct interpretation of thoracic HRCT for the procedure indication, is crucial for optimizing the usefulness of both techniques.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Costabel U, Guzman J. Bronchoalveolar lavage in interstitial lung disease. Curr Opin Pulm Med. 2001;7:255–61.
Travis WD, King TE, Bateman ED, et al. ATS/ERS international multidisciplinary consensus classification of idiopathic interstitial pneumonias. General principles and recommendations. Am J Respir Crit Care Med. 2002;165:277–304.
Bradley B, Branley HM, Egan JJ, Greaves MS, Hansell DM, Harrison NK, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008;63 Suppl 5:v1–58.
Xaubet A, Ancochea J, Blanquer R, Montero C, Morell F, RodrÃguez Becerra E, Sueiro A, Villena V, Grupo de Investigación en Enfermedades Pulmonares Intersticiales Difusas. Area de Técnicas y Transplante. SEPAR. Diagnosis and treatment of diffuse interstitial lung diseases. Arch Bronconeumol. 2003;39(12):580–600.
Drent M, Meyer KC, Baughman RP. Bronchoalveolar lavage. Prog Respir Res. 2007;36:58–67.
Kanne JP. Interstitial lung disease (ILD): imaging finding, and the role of imaging in the evaluating the patient with known or suspected ILD. Semin Roentgenol. 2010;45:3.
Meyer KC. Bronchoalveolar lavage as a diagnostic tool. Semin Respir Crit Care Med. 2007;28:546–60.
Meyer KC. The role of bronchoalveolar lavage in interstitial lung disease. Clin Chest Med. 2004;25(4):v637–49.
Ryu JH, Daniels CE, Hartman TE, Yi ES. Diagnosis of interstitial lung diseases. Mayo Clin Proc. 2007;82(8):976–86.
Baughman RP. Technical aspects of bronchoalveolar lavage: recommendations for a standard procedure. Semin Respir Crit Care Med. 2007;28:475–85.
Dhillon DP, Haslam PL, Townsend PJ, et al. Bronchoalveolar lavage in patients with interstitial lung diseases: side effects and factors affecting fluid recovery. Eur J Respir Dis. 1986;68:341–50.
Dohn MN, Baughman RP. Effect of changing instilled volume for bronchoalveolar lavage in patients with interstitial lung disease. Am Rev Respir Dis. 1985;132:390–2.
Rosell A, Xaubet A, Agustà C, Castella J, Puzo C, Curull V, de Gracia J, RASTA Study Group. A new BAL fluid instillation and aspiration technique: a multicenter randomized study. Respir Med. 2006;100(3):529–35.
Costabel U, Guzman J. Effect of smoking on bronchoalveolar lavage constituents. Eur Respir J. 1992;5:776–9.
Meyer KC, Soergel P. Bronchoalveolar lymphocyte phenotypes change in the normal aging human lung. Thorax. 1999;54:697–700.
Haslam PL, Baughmann RP. Guidelines for the measurement of acellular components and recommendations for standardization of bronchoalveolar lavage (BAL). Eur Respir Rev. 1999;9:25–157.
Baughman RP, Drent M. Role of bronchoalveolar lavage in interstitial lung disease. Clin Chest Med. 2001;22:331–41.
Meyer KC. The role of bronchoalveolar lavage in interstitial lung disease. Clin Chest Med. 2004;25:637–49.
Raghu G. Is bronchoalveolar lavage clinically useful for everyday practice in interstitial lung disease? Con: bronchoalveolar lavage. J Bronchol. 1999;6:217–21.
Meyer KC, Raghu G. Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful? Eur Respir J. 2011;38(4):761–9.
Martin RJ, Coalson JJ, Roger RM, et al. Pulmonary alveolar proteinosis: the diagnosis by segmental lavage. Am Rev Respir Dis. 1980;121:819–25.
Allen JN, Davis WB. Eosinophilic lung diseases. Am J Respir Crit Care Med. 1994;150:1423–38.
Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788–824.
Raghu G. Idiopathic pulmonary fibrosis: guidelines for diagnosis and clinical management have advanced from consensus-based in 2000 to evidence-based in 2011. Eur Respir J. 2011;37:743–6.
Welker L, Jörres RA, Costabel U, et al. Predictive value of BAL cell differentials in the diagnosis of interstitial lung diseases. Eur Respir J. 2004;24:1000–6.
Drent M, Mansour K, Linssen C. Bronchoalveolar lavage in sarcoidosis. Semin Respir Crit Care Med. 2007;28:486–95.
Costabel U, Guzman J, Bonella F, et al. Bronchoalveolar lavage in other interstitial lung diseases. Semin Respir Crit Care Med. 2007;28:514–24.
Hernandez Blasco L, Sanchez Hernandez IM, Villena Garrido V, de Miguel Poch E, Delgado Nuñez M, Alfaro Abreu J. Safety of the transbronchial biopsy in outpatients. Chest. 1991;99:562–5.
Churg A. Transbronchial biopsy: nothing to fear. Am J Surg Pathol. 2001;25:820–2.
Margaritopoulos GA, Wells AU. The role of transbronchial biopsy in the diagnosis of diffuse parenchymal lung diseases: Con. Rev Port Pneumol. 2012;18(2):61–3.
Poletti V, Casoni GL, Cancellieri A, Piciucchi S, Dubini A, Zompatori M. Diffuse alveolar damage. Pathologica. 2012;102:453–63.
Leslie KO, Gruden JF, Parish JM, Scholand MB. Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease. Arch Pathol Lab Med. 2007;131(3):407–23.
Colby TV, Fukuoka J, Ewaskow SP, Helmers R, Leslie KO. Pathologic approach to pulmonary hemorrhage. Ann Diagn Pathol. 2001;5:309–19.
Oliveira CC, Fabro AT, Ribeiro SM, Defaveri J, Capelozzi VL, Queluz TH, Yoo HH. Evaluation of the use of transbronchial biopsy in patients with clinical suspicion of interstitial lung disease. J Bras Pneumol. 2011;37(2):168–75.
Berbescu EA, Katzenstein AL, Snow JL, Zisman DA. Transbronchial biopsy in usual interstitial pneumonia. Chest. 2006;129:1126–31.
Martin WJ, Iannuzzi M, Gail DB, Peavy HH. Future directions in sarcoidosis research: summary of an NHLBI working group. Am J Respir Crit Care Med. 2004;170:567–71.
Costello LC, Hartman TE, Ryu JH. High frequency of pulmonary lymphangioleiomyomatosis in women with tuberous sclerosis complex. Mayo Clin Proc. 2000;75:591–4.
Agostini C, Miorin M, Semenzato G. Gene expression profile analysis by DNA microarrays: a new approach to assess functional genomics in diseases. Sarcoidosis Vasc Diffuse Lung Dis. 2002;19:5–9.
Thornhofer R, Maercker C, Popper HH. Expression of sarcoidosis related genes in lung lavage cells. Sarcoidosis Vasc Diffuse Lung Dis. 2002;19:59–65.
Selman M, Pardo A, Barrera L, et al. Gene expression profiles distinguish idiopathic pulmonary fibrosis from hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2006;173:188–98.
Magi B, Bini L, Perari MG, et al. Bronchoalveolar lavage fluid protein composition in patients with sarcoidosis and idiopathic pulmonary fibrosis: a two-dimensional electrophoretic study. Electrophoresis. 2002;23:3434–44.
Rottoli P, Magi B, Perari MG, et al. Cytokine profile and proteome analysis in bronchoalveolar lavage of patients with sarcoidosis, pulmonary fibrosis associated with systemic sclerosis and idiopathic pulmonary fibrosis. Proteomics. 2005;5:1423–30.
De Torre C, Ying S, Munson PJ, et al. Proteomic analysis of inflammatory biomarkers in bronchoalveolar lavage. Proteomics. 2006;6:3949–57.
Bowler RP, Ellison MC, Reisdorph N. Proteomics in pulmonary medicine. Chest. 2006;130:567–74.
Pajares V, Torrego A, Puzo C, Lerma E, Gil De Bernabé MA, Franquet T. Transbronchial lung biopsy using cryoprobes. Arch Bronconeumol. 2010;46:111–5.
Babiak A, Hetzel J, Krishna G, et al. Transbronchial cryobiopsy: a new tool for lung biopsies. Respiration. 2009;78:203–8.
Franke KJ, Theegarten D, Hann von Weyhern C, et al. Prospective controlled animal study on biopsy sampling with new flexible cryoprobes versus forceps: evaluation of biopsy size, histological quality and bleeding risk. Respiration. 2010;80(2):127–32.
Griff S, Ammenwerth W, Schönfeld N, et al. Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol. 2011;16(6):53.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Molina-Molina, M. (2013). Bronchoscopy Role in Interstitial Lung Disease. In: DÃaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_31
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6009-1_31
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6008-4
Online ISBN: 978-1-4614-6009-1
eBook Packages: MedicineMedicine (R0)