Abstract
Bronchoalveolar lavage (BAL) is a useful technique for differential diagnosis of various interstitial lung diseases (ILDs). The characteristics of BAL fluid of desquamative interstitial pneumonia (DIP) have not yet been fully elucidated; some authors described BAL eosinophilia as one of the characteristics of DIP, but there are only a few reports. Objective: this retrospective study was conducted to evaluate the additional utility of BAL for the diagnosis of DIP. Methods: BAL findings were studied retrospectively in 15 patients with a biopsy-proven DIP diagnosis and were compared with the BAL profile of 30 patients affected by other categories of idiopathic interstitial pneumonias with a preminent ground glass pattern on Computed Tomography: hypersensitivity pneumonitis (HP), non specific idiopathic pneumonia (NSIP), sarcoidosis. All patients underwent surgical lung biopsy. BAL was obtained before lung biopsy, or at the first patient evaluation; patients were followed-up for 4,04 years. Results: mean BAL eosinophils count was 7,36% in DIP patients and 2,11% in other IIP patients; mean BAL neutrophils count was 26,45% in DIP and 12,07% in other IIP patients; mean BAL lymphocytes count was 6% in DIP patients and 31,86% in other IIP patients. Logistic regression revealed a significant relation between BAL eosinophyls and the DIP diagnosis (p 0,037) and between BAL lymphocytosis and an alternative diagnosis (p < 0,01). BAL findings were not predictive of survival nor of changes in lung function in DIP patients. Conclusions: BAL findings can be helpful to discriminate the diagnosis between DIP and other IIP and should be considered in the multidisciplinary diagnosis of IIP.
- © 2014 ERS