Since the first lung irrigation was performed through a rigid bronchoscope in 1927, the procedure of BAL has advanced to become safer and better tolerated ( 1, 2).
Compared to sputum analysis, BAL allows for targeted sampling of the lower respiratory tract with less microbial contamination from the upper aerodigestive tract. It often provides valuable diagnostic information when clinical history, physical exam, routine laboratory testing, pulmonary function testing and radiographic imaging are insufficient to reach a definitive diagnosis. Accepted for publication Aug 12, 2020.īronchoalveolar lavage (BAL) is a common and relatively safe diagnostic procedure for the evaluation of patients with lung disease. Keywords: Bronchoalveolar lavage (BAL) bronchoscopy cell count differential lung disease pneumonitis signature Our review of the BAL literature is intended to serve as a resource to assist clinicians in the care of patients with lung disorders. Development of new diagnostic assays is certain to reinforce the utility of BAL in the future. While some pulmonary disorders have a highly characteristic signature of BAL findings, BAL results alone often lack specificity and require interpretation along with other clinical and radiographic details. Since the performance of the first lung irrigation in 1927, BAL has become a common and important diagnostic tool. This review focuses on common cellular and molecular findings of BAL in a wide range of lung diseases. In addition, more specific diagnostic tests including molecular assays such as polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay, special cytopathologic stains, or particular microscopic findings have been described as part of BAL fluid analysis. In many circumstances, BAL differential cell counts have been reported to be typical of specific lung disorders. Abstract: Bronchoalveolar lavage (BAL) is a commonly used procedure in the evaluation of lung disease as it allows for sampling of the lower respiratory tract.
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