Diagnostic utility of bronchoalveolar lavage in pulmonary disorders

Abstract

Background

Pulmonary diseases represent a significant global health challenge, underscoring the need for accurate diagnostic methods to ensure effective management. Bronchoalveolar lavage (BAL) is an essential diagnostic tool, providing valuable insights into various lung conditions. However, despite its widespread application in pulmonology, limited studies have thoroughly evaluated its diagnostic value.

Materials and methods

A retrospective cohort study was conducted over one year to assess the diagnostic utility of BAL. Samples were obtained from patients undergoing BAL as part of their diagnostic workup. Demographic and clinicoradiological data were documented. The BAL fluids were processed and evaluated cytologically, with samples classified into diagnostic categories. In malignant cases, histopathological correlation was performed.

Results

A total of 187 BAL fluid samples were analysed, yielding diagnoses that included malignancy (7%), specific infections (6%), inflammatory conditions (43%), and others. BAL demonstrated high efficacy in identifying malignancies (PPV: 85%) and specific infections such as tuberculosis and fungal pneumonia. Histological correlation confirmed the diagnostic accuracy of BAL in malignancies, with a concordance rate of 78%.

Conclusion

BAL has proven to be a reliable method for detecting both neoplastic and non-neoplastic lung lesions. Its minimally invasive nature makes it a preferred alternative to needle biopsies, particularly in critically ill patients. Even when findings are nonspecific, BAL helps narrow down differential diagnoses. Additionally, the samples obtained can be used for molecular and microbiological analyses, further enhancing its diagnostic capabilities.