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Bronchoalveoläre Lavage

Bronchoalveolar lavage

Zusammenfassung

Die bronchoalveoläre Lavage (BAL) ist eine etablierte Methode, um mit Hilfe eines Bronchoskops Material von den peripheren Atemwegen wie den terminalen Bronchiolen und den Alveolen zu gewinnen. Bei Beachtung der Standardprotokolle wird sie vom Patienten gut vertragen und spielt daher eine wichtige Rolle bei der Diagnose von interstitiellen Lungenerkrankungen und auch von Infektionskrankheiten. Bei bestimmten Krankheitsbildern wie z. B. der Alveolarproteinose oder einer Langerhans-Zell-Histiozytose erlauben spezifische Befunde, auf eine invasive Diagnostik zu verzichten. Bei anderen Erkrankungen ist in vielen Fällen eine Einengung der Differenzialdiagnosen möglich. Dennoch kann bis heute häufig nicht gänzlich auf die Biopsie verzichtet werden. Die Kombination beider Methoden erlaubt in Zusammenschau mit den klinisch erhobenen Befunden eine zuverlässige Diagnostik sowie die Erforschung der pathologischen Veränderungen bei Entzündungen und fibrosierenden Lungenerkrankungen.

Abstract

Bronchoalveolar lavage (BAL) has become an established method for the diagnosis of infectious and interstitial lung diseases. Using a bronchoscope material from the peripheral airways and aleveolar spaces can be obtained. When standard protocols are followed the procedure is generally well tolerated and in combination with clinical tests allows a reliable diagnosis in many cases. Certain clinical entities, e.g. alveolar proteinosis and Langerhans cell histiocytosis can be diagnosed by BAL alone without resorting to invasive diagnostic tests. In other diseases, BAL allows to narrow the range of the differential diagnosis. However, biopsies can often still not be avoided completely. A combination of both methods together with the clinical findings represents a powerful tool for diagnosis and research into the pathologic alterations in inflammatory and fibroising lung diseases.

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Correspondence to M. Tötsch.

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Tötsch, M., Guzman, J., Theegarten, D. et al. Bronchoalveoläre Lavage. Pathologe 28, 346–353 (2007). https://doi.org/10.1007/s00292-007-0926-6

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Schlüsselwörter

  • Lunge
  • Bronchoalveoläre Lavage (BAL)
  • Interstitielle Lungenerkrankung
  • Infektionskrankheiten

Keywords

  • Lung
  • Bronchoalveolar lavage (BAL)
  • Interstitial lung disease
  • Infectious disease