ISSN: 2041-6792

Clinical Investigation

Bronchoalveolar Journals

Bronchoalveolar lavage (BAL) has been generally recognized as a healthy technique for the extraction of respiratory secretions for the analysis of cellular and acellular components for diagnostic and testing purposes. When BAL was initially developed as a method for analyzing respiratory secretions in animal lung disease models and subsequently adapted as a clinical tool for researching interstitial lung disease (ILD), it was viewed as promising for the diagnosis and treatment of various types of ILD, such as sarcoidosis, idiopathic pulmonary fibrosis (IPF) and pneumonitis hypersensitivity (HP). Nonetheless, in the following decades, hundreds of publications have been published in the scientific literature as numerous centers around the world started using BAL to classify respiratory infection agents and investigate causes of changes in the composition of the airspace environment associated with the prevalence of non-infectious parenchymal lung diseases. BAL is also widely used as a method for diagnosing respiratory infections, assessing patients with acute respiratory failure or signs of diffuse parenchymal lung diseases, and tracking the transplanted lung allograft status. Notwithstanding widespread use of BAL by pulmonologists, cellular analysis of BAL, especially nucleated differential counts of immune cells, may be underused in diagnosis of ILD. Knowledge obtained from the presence of BAL and differential cell counts may provide valuable diagnostic clues if correctly understood and interpreted with sufficient knowledge of possible diagnoses associated with unique cellular patterns of BAL.

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