Role of Bronchoalveolar Lavage in Undiagnosed Lung Diseases.

Introduction: Bronchoalveolar lavage (BAL) is a diagnostic procedure by which cells and other components from bronchial and alveolar spaces are obtained for various studies. One of the main advantages of BAL is that it can be done as a day care procedure. Material obtained by BAL can give a definite diagnosis in conditions such as infections and malignancies. Aim: To assess the utility of BAL as a tool to determine the diagnostic accuracy of the material obtained from BAL in various infections and neoplastic lesions and to study the limitations of BAL in certain lung disorders. Material and Methods: This study was done in a tertiary care center and teaching college in North India. Bronchoscopy was done in 120 cases and lavage fluid was obtained. Microbiological examination and cytological evaluation was done for each case. Cases selected included non-resolving pneumonias, diffuse lung infiltrates, and ventilator- associated pneumonias. It is an observational and cross-sectional study with intent to look for findings in bronchoalveolar lavage in suspected lung disease. During our study, BAL was done in 120 patients and results were analyzed by calculating percentage, proportion and mean. Analysis was done using the SPSS version 20. Descriptive statistics and diagrammatic representation were performed to describe the studied variables. Results: Bronchoalveolar lavage was done in 120 cases over a period of 1 year. Tuberculosis was diagnosed in 10 cases, fungal infections in 7 cases. Twenty-two cases of bacterial pneumonias were diagnosed; Klebsiella, Streptococcus and Pneumococcus were the most common organism. Malignancy was diagnosed in thirty-six cases. Adenocarcinoma was the most common type identified. Conclusion: Definite diagnosis can be made in tuberculosis, fungal infections, bacterial pneumonias and in malignancies. It is not only used as a useful diagnostic tool in diagnosing bacterial pneumonias, tuberculous lesions, fungal infections but also malignancies and diffuse lung diseases (DLDs).Its role is limited in diagnosing and prognosticating DLDs. The number of lesions with a definite diagnosis outnumber the lesions that cannot be diagnosed hence we opine that BAL is a useful diagnostic modality not only for routine diagnosis, butals of orancillary techniques and research purpose. [ABSTRACT FROM AUTHOR]