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Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias
- Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias
- Ryu, Yon Ju; Chung, Man Pyo; Han, Joungho; Kim, Tae Sung; Lee, Kyung Soo; Chun, Eun-Mi; Kyung, Sun Young; Jeong, Sung Hwan; Colby, Thomas V.; Kim, Hojoong; Kwon, O. Jung
- Ewha Authors
- 천은미; 류연주
- SCOPUS Author ID
- 천은미; 류연주
- Issue Date
- Journal Title
- RESPIRATORY MEDICINE
- vol. 101, no. 3, pp. 655 - 660
- idiopathic interstitial pneumonia; usual interstitial peumonia; non-specific interstitial pneumonia; bronchoalveolar lavage
- W B SAUNDERS CO LTD
- SCI; SCIE; SCOPUS
- The purpose of this study was to assess the role of bronchoalveolar lavage (BAL) in differentiating usual interstitial peumonia (UIP) from non-specific interstitial pneumonia (NSIP) and in predicting the prognosis in fibrotic idiopathic interstitial pneumonia (IIP). A retrospective review of 122 patients (age 58+8 years, 70 mate) with UIP (n = 87) and NSIP (n = 35) was carried out. Prior to surgical lung biopsy, all of them underwent BAL and high-resolution-computed tomography (HRCT) of the chest. Neutrophil count in BAL fluid was higher in UIP (7.0%) than NSIP (3.0%) (P = 0.027). In contrast, BAL lymphocyte count was significantly higher in NSIP (29.0%) than UIP (5.5%) (P < 0.0001). In 62 patients whose HRCT findings were atypical for UIP, BAL lymphocytosis was more frequently observed in NSIP (20/33) than UIP (4/29) (P < 0.001) and the absence of BAL lymphocytosis suggested a diagnosis of UIP rather than NSIP (odds ratio 12.7, P < 0.001). Pathologic diagnosis of NSIP was the only independent factor predicting a longer survival of our patients (median follow-up 21 months) (hazard ratio (HR) 0.035, P = 0.005). When NSIP was not included in the survival analysis, higher BAL lymphocyte count was the only independent predictor of a longer survival (HR 0.909, P = 0.029). BAL is an useful non-invasive tool. in fibrotic IIP, not only for excluding a variety of specific non-IIP diseases but also for narrowing the differential diagnosis and predicting the prognosis in the absence of the histopathologic diagnosis. (c) 2006 Elsevier Ltd. All rights reserved.
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