Department of Pathology, PGIMER, Chandigarh, India.
Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India.
Diagn Cytopathol. 2020 Dec;48(12):1290-1299. doi: 10.1002/dc.24574. Epub 2020 Aug 8.
Bronchoalveolar lavage (BAL), is a safe, minimally invasive procedure to sample the terminal airways and the lung parenchyma. Although frequently used, there is lack of contemporary literature regarding the diagnostic utility of BAL for various pulmonary diseases. This study was conducted to evaluate the utility of BAL in diagnosis of various pulmonary pathologies, both infectious and neoplastic.
This was a retrospective study performed over a period of 2 years. All the BAL samples reported on cytology were studied, their clinical details were retrieved, and the corresponding smears were reviewed. Cyto-histopathologic correlation was done, wherever possible.
There were a total of 1835 cases (1153 men, 682 women; age, 8 months to 78 years). Of these, 19 (1%) cases were assessed as inadequate for opinion. In 348 (19%) cases, specific infective cause could be identified on BAL cytology alone. Tuberculosis and fungal infections could be diagnosed in 165 (9%) and 178 (9.7%) cases respectively. There were 46 (2.5%) neoplasms, including adenocarcinoma (n = 20), squamous cell carcinoma (n = 5), small cell carcinoma (n = 2), Langerhans cell histiocytosis (n = 1), suspicious for malignancy (n = 15) and metastatic carcinoma (n = 3). Some rare diagnoses were also reported on BAL cytology, including sarcoidosis, actinomycosis, leishmaniasis, pulmonary alveolar proteinosis and metastatic papillary carcinoma of the thyroid.
BAL is a safe and useful procedure for primary diagnosis of infections such as tuberculosis and fungal infections, which has special significance in developing nations where prevalence of such infections is high. In addition, BAL has the potential to diagnose both primary as well as secondary malignant lung lesions.
支气管肺泡灌洗（BAL）是一种安全、微创的方法，可用于采样终末气道和肺实质。尽管经常使用，但关于 BAL 在各种肺部疾病中的诊断效用的当代文献仍然缺乏。本研究旨在评估 BAL 在诊断各种肺部疾病（包括感染性和肿瘤性疾病）中的效用。
这是一项为期 2 年的回顾性研究。对报告的细胞学 BAL 样本进行了研究，检索了其临床详细信息，并对相应的涂片进行了回顾。在可能的情况下进行了细胞组织病理学相关性研究。
共有 1835 例（1153 名男性，682 名女性；年龄 8 个月至 78 岁）。其中，19 例（1%）被评估为无法提供意见。在 348 例（19%）中，仅通过 BAL 细胞学即可确定特定的感染性病因。分别在 165 例（9%）和 178 例（9.7%）中诊断出结核病和真菌感染。有 46 例（2.5%）肿瘤，包括腺癌（n=20）、鳞状细胞癌（n=5）、小细胞癌（n=2）、朗格汉斯细胞组织细胞增生症（n=1）、疑似恶性肿瘤（n=15）和转移性癌（n=3）。BAL 细胞学还报告了一些罕见的诊断，包括结节病、放线菌病、利什曼病、肺泡蛋白沉积症和甲状腺乳头状癌的转移性。
BAL 是一种安全且有用的方法，可用于原发性诊断感染，如结核病和真菌感染，在感染率较高的发展中国家具有特殊意义。此外，BAL 还有潜力诊断原发性和继发性恶性肺部病变。
