Cellular analysis of bronchoalveolar lavage fluid in various lung lesions

  • Dr. Kajal B. Punyashetty Professor, Department of Pathology, Navodaya Medical College, Raichur, Karnataka, India
  • Dr. Padma Shree Solanki Navodaya Medical College, Raichur, Karnataka, India
  • Dr. Anand A. S. Professor and Head, Department of Pathology, Navodaya Medical College, Raichur, Karnataka, India
Keywords: Automated six-part analyzer, Bronchoalveolar lavage fluid, Lung diseases

Abstract

Introduction: Bronchoalveolar lavage (BAL) is a standard tool in the diagnosis of lung diseases. Cellular analysis of BAL fluid when deviates from normal are indicative of an inflammatory/infiltrative process. This study involves an analysis of BAL fluid performed manually and also using an automated analyzer which offers a rapid and reliable method for analysis of unprocessed BAL fluid.

Aims and Objectives: To utilize the cellular analysis of bronchoalveolar lavage (BAL) fluid in the diagnosis of various lung diseases.

Materials and Methods: 37 patients with pulmonary diseases of varying etiologies were included in this study. Fiberoptic bronchoscopy with BAL was performed. BAL fluid was run in SYSMEX XNL/350 six-part analyzer which gave total and differential cell count (mononuclear and polymorphonuclear cells). The sample was also centrifuged, sediment smears prepared and differential cell counts were determined.

Results: Total WBC count ranged from 31 cells/µl to 94 cells/µl with the maximum increase seen in asthma. Mononuclear cells were increased in the majority of cases, being 84% in pneumoconiosis with the predominance of macrophages. An increase in lymphocytes was seen in Non-Specific Interstitial Pneumonia (45.3%) and Bronchiolitis Obliterans Organising Pneumonia (35.3%), neutrophils in Usual Interstitial Pneumonia (26.2%) and eosinophils in Chronic Eosinophilic Pneumonia (55.5%) and asthma (8.4%). There were 58% mononuclear cells and 42% polymorphonuclear cells in tuberculosis. There were two cases of adenocarcinoma and one case of squamous cell carcinoma in the present study.

Conclusion: BAL cell differentials when combined with additional clinical and radiographic information help secure a confident diagnosis in lung diseases and help clinicians to make therapeutic decisions.

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Published
2020-02-29
How to Cite
B. Punyashetty, K., Shree Solanki, D. P., & A. S., A. (2020). Cellular analysis of bronchoalveolar lavage fluid in various lung lesions. Pathology Update: Tropical Journal of Pathology and Microbiology, 6(2), 168-174. https://doi.org/10.17511/jopm.2020.i02.09
Section
Original Article