Bronchoalveolar lavage in lung cancer

The analysis of soluble and cellular components of bronchoalveolar lavage (BAL) fluids might help the diagnosis of a specific tumour. Up to now disease specific humoral constituents have not yet been found. Concerning cellular recovery, BAL can be useful particularly in patients with bronchiolo-alveolar carcinoma. The overall diagnostic yield in the case series presently available in the literature ranges from 35 to 69%. We evaluated the usefulness of BAL in the diagnosis of diffuse neoplastic lung lesions. The BAL provided a diagnostic yield in 75.9% of patients with biopsy or autopsy proven neoplasm, the sensitivity varying according to the type and growth pattern of the tumour (93% in bronchioloalveolar carcinoma). BAL can prove useful also in the diagnosis of pulmonary involvement in lymphoproliferative disorders, particularly when the immunologic evaluation of surface markers is performed. We conclude that in the appropriate setting BAL represents a useful tool for studying patients with lung cancer.