Tötsch M, Guzman J, Theegarten D, Schmid K W, Costabel U
Institut für Pathologie und Neuropathologie, Universitätsklinikum Essen,Westdeutsches Tumorzentrum Essen, 45122, Essen.
Pathologe. 2007 Sep;28(5):346-53. doi: 10.1007/s00292-007-0926-6.
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 alveolar 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.
支气管肺泡灌洗术(BAL)已成为诊断感染性和间质性肺疾病的既定方法。通过支气管镜可以获取外周气道和肺泡腔的物质。遵循标准方案时,该操作通常耐受性良好,并且与临床检查相结合,在许多情况下可实现可靠的诊断。某些临床病症,如肺泡蛋白沉积症和朗格汉斯细胞组织细胞增多症,仅通过BAL即可诊断,无需借助侵入性诊断测试。在其他疾病中,BAL有助于缩小鉴别诊断的范围。然而,活检往往仍无法完全避免。这两种方法与临床发现相结合,是诊断和研究炎症性和纤维化性肺疾病病理改变的有力工具。