[Diagnostic value of fiberoptic bronchoscopy in pneumopathies in immunodeficient adults: a report on 59 examinations (author's transl)].

Fifty-nine fiberoptic examinations with endobronchial sampling, brushings, distal bronchial biopsy, and alveolar lavage were conducted during the course of recent pneumopathies in immunodeficient adults with malignant hemopathies (41 cases), solid tumors (7 cases), and other affections (11 cases). Diagnosis was established by fiberoptic bronchoscopy in 4 cases with specific locations of hemopathy or cancer, after bronchial biopsy, in 5 cases of mycoses, after bronchial biopsy, aspiration and/or alveolar lavage, in 4 patients with bacterial pneumonia after bronchial aspiration, and in 1 case of pneumocystosis, after distal biopsy. Diagnosis was not confirmed in the other cases. Mortality (50 p. cent) was similar in the diagnosed group and the group without confirmation of diagnosis. No significant complications due to the examination were observed, except for worsening of the respiratory condition in 7 patients with hypoxemia. The role of fiberoptic bronchoscopy in causing these alterations cannot be excluded. Fiberoptic bronchoscopy appears to be a safe examination except in patients with hypoxemia (PaO2 less than or equal to 50 mmHg). Distal biopsy appeared to be of less value than bronchial biopsy in these patients, as there was a positive correlation between the results of the latter examination and the macroscopic lesions observed in all cases.