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Diagnostic Yield of BAL Fluid Cytology in Hematologic Malignancies

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Pulmonary Involvement in Patients with Hematological Malignancies

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Abstract

The use of BAL to investigate the alveolar component of the patient’s lung has been widely developed since the mid 1970s; however the need for diagnostic BAL in patients with hematologic malignancies is considered to have decreased over the last 10 years. A major question in 2010 is therefore: what is the real value of BAL in everyday management of these patients? The aim of this chapter is to discuss clearly the various areas in which cytological examination of BAL fluid remains a particularly useful diagnostic tool in these patients.

The diagnosis of pulmonary diseases associated with hematologic malignancies, such as pulmonary hemorrhage and pulmonary alveolar proteinosis, is based on BAL analysis not requiring pathologic examination of tissue samples. In primary lung lymphomas, BAL cytology is a particularly valuable first-line diagnostic procedure, and, in other situations, BAL cytology may make a major contribution to the diagnostic decision.

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Acknowledgments

The authors would like to thank Marie-José Pocholle, Christine Carre, (Unité de Cytopathologie Hôpital Henri Mondor Créteil France), Danièle Cesari, Claudie Prengel and Patricia Roynard (Unité de Cytopathologie Hôpital Tenon Paris France) for their excellent technical assistance in cytopathology and cytometry over all these years and Marie-Claire Pinchon † and Anne Marie Vojtek (Laboratoire de Microscopie Electronique CHIC Creteil France) for their valuable expertise in electron microscopy of BAL.

They would also like to thank Catherine Cordonnier, MD, and Estelle Escudier, MD, from the Hematology Department of Hôpital Henri Mondor Créteil France, with whom we developed our work on BAL 25 years ago, and Anne Fajac, MD, who joined us more recently on this topic.

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  1. Cytopathology Unit, Laboratoire d’Histologie Biologie Tumorale, Université Pierre et Marie Curie Paris 6, Hôpital Tenon APHP, 75020, Paris, France

    Jean-François Bernaudin & Jocelyne Fleury-Feith

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  1. Jean-François Bernaudin
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  2. Jocelyne Fleury-Feith
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Correspondence to Jean-François Bernaudin .

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  1. Service de Réanimation Médicale, Hôpital Saint Louis, Avenue Claude Vellefaux 1, Paris, 75010, France

    Elie Azoulay

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Bernaudin, JF., Fleury-Feith, J. (2011). Diagnostic Yield of BAL Fluid Cytology in Hematologic Malignancies. In: Azoulay, E. (eds) Pulmonary Involvement in Patients with Hematological Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15742-4_17

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