Bronchoalveolar Lavage Total Cell Count in Interstitial Lung Diseases—Does It Matter?
- 860 Downloads
Bronchoalveolar lavage (BAL) is a useful technique for differential diagnosis of various interstitial lung diseases (ILDs) and is usually realized by analysis of the differential cell count. This study was conducted to estimate the value of bronchoalveolar lavage fluid (BALF) total cell count (TCC) in the diagnosis of ILD. We analyzed 237 BAL samples from patients with ILD: sarcoidosis (SA), idiopathic pulmonary fibrosis (IPF), cryptogenic organizing pneumonia (COP), hypersensitivity pneumonitis (HP), chronic eosinophilic pneumonia (CEP), and smoking-related ILD (sr-ILD). The control group consisted of 30 healthy volunteers. The statistical analysis revealed significant differences in the BALF TCC between healthy controls and patients with SA, IPF, HP, COP, sr-ILD, and eosinophilic disorders (mean values 6.9 vs. 14.5, 22.5, 22.8, 20.7, 64.5, and 27.3 × 106, respectively). Logistic regression revealed a significant relation between the TCC and ILD diagnosis. We conclude that the TCC, as well as the value of total number of inflammatory cells, should be reported in the description of BAL.
KEY WORDSinterstitial lung diseases total cell count BAL
The authors wish to thank Dr Zbigniew Lewandowski for his help in the statistical analysis.
- 5.American Thoracic Society. 2002. European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. American Journal of Respiratory and Critical Care Medicine 65: 277–304.Google Scholar
- 6.Bradley, B., H.M. Branley, J.J. Egan, M.S. Greaves, D.M. Hansell, N.K. Harrison, N. Hirani, R. Hubbard, F. Lake, A.B. Millar, W.A. Wallace, A.U. Wells, M.K. Whyte, and M.L. Wilsher. 2008. 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 63(Suppl 5): v1–v58.PubMedGoogle Scholar
- 7.Technical recommendations and guidelines for bronchoalveolar lavage (BAL). Report of the European Society of Pneumology Task Group: Eur Respir J 1989; 2:561–585Google Scholar
- 11.Tabuena, R.P., S. Nagai, T. Tsutsumi, T. Handa, T. Minoru, T. Mikuniya, M. Shigematsu, K. Hamada, T. Izumi, and M. Mishima. 2005. Cell profiles of bronchoalveolar lavage fluid as prognosticators of idiopathic pulmonary fibrosis/usual interstitial pneumonia among Japanese patients. Respiration 72: 490–498.PubMedCrossRefGoogle Scholar
- 14.Bronchoalveolar lavage constituents in healthy individuals, idiopathic pulmonary fibrosis, and selected comparison groups. The BAL Cooperative Group Steering Committee. Am Rev Respir Dis 1990;141:S169–S202Google Scholar
- 15.Costabel U. 1998. Atlas of Bronchoalveolar Lavage. Chapman and Hall Medical.Google Scholar
- 19.Spagnolo, P., L. Richeldi, and G. Raghu. 2009. The role of bronchoalveolar lavage cellular analysis in the diagnosis of interstitial lung diseases. European Respiratory Society Monograph 46 (Interstitial Lung Diseases): 36–46.Google Scholar
- 24.Antoniou, K.M., D.M. Hansell, M.B. Rubens, K. Marten, S.R. Desai, N.M. Siafakas, A.G. Nicholson, R.M. du Bois, and A.U. Wells. 2008. Idiopathic pulmonary fibrosis: Outcome in relation to smoking status. American Journal of Respiratory and Critical Care Medicine 177: 190–194.PubMedCrossRefGoogle Scholar
- 25.Steele, M.P., M.C. Speer, J.E. Loyd, K.K. Brown, A. Herron, S.H. Slifer, L.H. Burch, M.M. Wahidi, J.A. Phillips III, T.A. Sporn, H.P. McAdams, M.I. Schwarz, and D.A. Schwartz. 2005. Clinical and pathologic features of familial interstitial pneumonia. American Journal of Respiratory and Critical Care Medicine 172: 1146–1152.PubMedCrossRefGoogle Scholar