1991 Volume 13 Issue 3 Pages 235-241
We performed a combination of bronchoscopic curettage and, broncho-alveolar lavage (BAL) in 70 cases with peripheral solitary shadows admitted after October, 1985. Definite diagnoses were made in 69 cases after performing this method together with operations or autopsies : malignant tumors 28 cases (40%), general bacterial infections. e.g. lung abscess. infected bronchectasis pneumonia etc. 24 cases (35%), pulmonary tuberculosis 13 cases (19%) and others 4 cases (6%), Infectious diseases account for more than 50% of peripheral solitary shadows and the rate of tuberculosis is still high. By sputum cytology, conventional X-ray examinations and this method. final diagnoses were obtained in 47 cases (67%). The diagnostic percentage for each disease were ; 50% for malignant tumors, 88% for general bacterial infections excluding the detection of causative bacterira, 85% for tuberculosis and 25% for other diseases. Diagnostic rate of malignant tumors was 57% after including curettage, BAL fluid cytology and transbronchial lung biopsy (TBLB). But the diagnostic rate of this method was superior to that of TBLB alone. No metastatic lung tumors could be diagnosed by this method and TBLB. In 8 (22%) out of 37 infectious disease cases the results of sputum and BAL fluid culture coincided. By including BAL fluid stain and culture, causative bacteria were detected in 25 cases (68%). Causative tuberculosis bacilli, anaerobic bacteria and fungi were detected more frequently in BAL fluid than in sputum. These results were considered to show the present state, limitations and future problems of this method.
