Comparison of the cell content of lung lavage fluid with the presence of emphysema and peripheral airways inflammation in resected lungs.

This study was designed to investigate the relationship between the cellular components of lung lavage fluid and the presence of airways disease and emphysema in resected lung specimens, primarily from current and ex-smokers. Since standard bronchopulmonary lavage cannot be performed on these specimens, an intrapulmonary lavage technique was developed and compared to the results of bronchoalveolar lavage performed prior to surgery on the lung or lobe opposite to the one resected. The specimen lavage produced inflammatory cell differential counts similar to those obtained by bronchopulmonary lavage, and studies on postmortem lungs showed that the fluid washed alveoli, respiratory and membranous bronchioles, and small cartilaginous bronchi. The results show that the variation in peripheral airways inflammation and extent of lung destruction by emphysema did not correlate with the variation in cell content observed in the lavage fluid. Similarly, the differential counts performed in the lavage fluid did not correlate with the smoking habits of the patient. We conclude that the changes in cell content of the lavage fluid do not reflect the extent or severity of the inflammatory disease and lung destruction present in the lungs of this group of patients.