Asbestos bodies in bronchoalveolar lavage

Asbestos bodies (AB) were counted in bronchoalveolar lavage (BAL) fluid from 62 patients with suspected asbestos related diseases, 2 patients with known exposure to asbestos but without related disease, and 40 control subjects. BAL fluid contained AB in all patients with obvious exposure (28 of 28), including the 2 without related disease, in most patients with suspected exposure (26 of 28), as well as in 5 of 8 patients without known exposure but with suspicion of asbestos related disease (mesothelioma or pleural plaques). Among the 40 control subjects, the results in 5 were positive but to a low degree (less than 1 AB/ml of fluid). Quantitative analysis correlated with the type of disease: AB counts were higher in patients with interstitial lung disease than in those with benign (p less than 0.02) or malignant (p less than 0.01) pleural disease. Only 9 of 13 patients with mesothelioma had a positive lavage. In conclusion, the finding of AB in BAL fluid correlates with the occupational risk and can disclose unknown exposure better than a questionnaire, but a positive lavage is not a proof of disease. Quantitative differences in AB counts suggest a different pathogenesis for pleural and parenchymal disease.