Abstract
In order to examine the diagnostic value of broncho-alveolar lavage (BAL) for diffuse interstitial pulmonary diseases, we performed BAL in young healthy normal volunteers (17 cases), control patients with an average age of 58 (37 cases), patients with diffuse interstitial fibrosing pneumonia (DIFP) (16 cases), patients with hypersensitivity pneumonitis (6 cases) and patients with sarcoidosis (5 cases), and analyzed the cellular and protein contents in the lavage fluids.
A segment or subsegment of the right middle lobe/or lingula was lavaged with 50ml of saline with 3 times. In control patients, the lavage was done at the site free from lesion. A site related to the pulmonary disease should be lavaged in order to obtain broncho-alveolar components with constantly high yield. Age-matched controls are necessary for evaluation of the nature and extent of diffuse interstitial pulmonary diseases. Various components in the broncho-alveolar lavage fluid (BALF) must be expressed not only as concentration in BALF but also as ratios to other components, in order to evaluate the nature and extent of diffuse interstitial disease accurately.
Cellular and protein components of BALF in the 5 groups were analysed. It was concluded that analysis of cells in BALF obtained from patients with hypersensitivity pneumonitis (HP) was highly diagnostic. The increased number of lymphocytes in HP may be related to the etiology of HP. BALF from patients with chronic DIFP showed an increased number of polymorphic nuclear neutrophils compared to controls.
