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Updated: Mar 21, 2026
Bronchoalveolar Lavage of Murine Lungs to Analyze Inflammatory Cell Infiltration
Published on: May 4, 2017
Bronchoalveolar lavage cellular analyses in conjunction with high-resolution computed tomography imaging as a
Ammaiyappan Chockalingam1, Ranganathan Duraiswamy1, Madhavan Jagadeesan2
1Department of Thoracic Medicine, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India.
Insights
Optimized bronchoalveolar lavage (BAL) combined with clinical and HRCT findings improves interstitial lung disease (ILD) diagnosis. This approach enhances accuracy in identifying ILD causes and managing acute exacerbations.
Area of Science:
- Pulmonary Medicine
- Diagnostic Imaging
- Respiratory Pathology
Background:
- Bronchoalveolar lavage (BAL) is accepted for diagnosing interstitial lung diseases (ILDs).
- High-resolution computed tomography (HRCT) has impacted the clinical utility of BAL.
- This study optimized BAL according to American Thoracic Society (ATS) guidelines, integrating findings with clinical and HRCT data.
Purpose of the Study:
- To optimize the bronchoalveolar lavage (BAL) procedure for diagnosing interstitial lung diseases (ILDs).
- To integrate BAL findings with clinical examination and high-resolution computed tomography (HRCT) for precise ILD diagnosis.
- To assess the diagnostic utility of optimized BAL in various ILD subtypes.
Main Methods:
- Bronchoalveolar lavage (BAL) performed on ILD suspects at HRCT-identified sites.
- BAL fluid processing and analysis adhered strictly to ATS guidelines.
- Diagnosis involved correlating clinical data, HRCT findings, and BAL reports; statistical analysis was performed.
Main Results:
- Optimized BAL procedure validated per ATS recommendations.
- Diagnosed 50 patients with various ILDs including idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and connective tissue disorders.
- Significant variations in differential cell counts were observed across different ILDs, aiding classification.
Conclusions:
- BAL, integrated with clinical and HRCT findings, enhances diagnostic accuracy for ILDs.
- This combined approach improves the understanding of disease chronicity and acute exacerbation causes.
- Enhanced diagnostic capability facilitates better patient management strategies for ILDs.
Background:
Bronchoalveolar lavage (BAL) has gained acceptance for diagnosis of Interstitial lung disease (ILD). The advent of high-resolution computed tomography (HRCT) has reduced the clinical utility of BAL. This work has utilized the recommendations of the American Thoracic Society (ATS) to optimize BAL and the findings have been associated with clinical examination and HRCT to precisely narrow down the cause of ILD.
Materials And Methods:
BAL was performed on ILD suspects at the target site chosen based on HRCT. The procedure, transport, processing, and analysis of BAL fluid were performed as per the ATS guidelines. The clinical data, HRCT findings and BAL report were used to narrow down the diagnosis of ILD. The statistical analysis was performed to assess the significance.
Results:
The BAL procedure was optimized as per the recommendations of the ATS. In a cohort of 50 patients, Idiopathic pulmonary fibrosis, (8) hypersensitivity pneumonitis, (17) connective tissue disorder, (9) sarcoidosis, (3) pneumoconiosis, (5) acute respiratory distress syndrome, (2) eosinophilic lung disease (2) and lymphangitic carcinomatosa, (2) aspiration bronchiolitis (1) and pulmonary histiocytosis (1) were diagnosed. Statistically significant variation in differential counts was found in different ILDs. The different ILDs were classified based on the criteria described by the ATS.
Clinical Significance:
BAL along with clinical and HRCT findings improved the diagnostic accuracy by incorporating, the acute or chronic nature of the disease and the cause for acute exacerbation, which helped in the better management of ILDs.
