Correlation between imaging fibrosis severity and bronchoalveolar lavage pattern in interstitial lung disease

Abstract

Aim: To assess correlation between fibrosis severity and bronchoalveolar lavage (BAL) profile in interstitial lung disease (ILD). Methods: A retrospective study was conducted including 111 patients with confirmed diagnosis of ILD by HRCT. Semi-quantitative scale as proposed by Warrick was used. Total score (TS), indices for alveolitis (AI) and fibrosis (FI) were assessed. According to the total score, fibrosis was classified as mild ( 15. BAL was performed in 82% of cases. Results: Mean age was 59.3 years. Sex ratio was 0.76. Main etiologies were idiopathic ILD (38.7%), sarcoidosis (28.8%) and connectivite tissue diseases (13.5%). Most frequent Warrick elementary lesions were septal and no septal lines (77.5%) and ground glass opacities (48.6%). TS, AI and FI were 1.67±1.73; 9 ± 5.8 and 10.2 ±6.3 respectively. Fibrosis was mild (31.5%), moderate (51.4%) and severe (17.1%). Patients with mild fibrosis had greater BAL lymphocyte counts and CD4/CD8 ratio (p=0.043 and 0.031) and lower eosinophil rates (p=0.04). There were no correlations between BAL profiles and AI. Whereas significant correlations were found between TS and FI and lymphocyte (p=0.001; r=-0.33 and p Conclusion: Fibrosis extent and severity in ILD correlate with neutrophil rates and inversely with lymphocyte counts in BAL.