ASSESING THE CLINICAL UTILITY OF BROCHOALVEOLAR LAVAGE(BAL) CELLULAR ANALYSIS IN DISEASES OF LUNG

Abstract

Background: Respiratory tract cytology is well established throughout the world as a vital diagnostic procedure in the evaluation of lung disease. Though Bronchoalveolar lavage (BAL) was developed as a research rool, with the introduction of fibreoptic bronchoscopes (FOB) it became popular in clinical practice.BAL is a saline wash of the respiratory tract. Aims and Objectives: 1) Number of Indian studies on this topic are less. So we wanted to assess the diagnostic utility in clinical practise. 2) To find out BAL‘s diagnostic accuracy. 3) To study Bal’s advantages and disadvantages in our area. 4) Comparing with biopsies and other tests, and clinical findings.

Methods: In this prospective study all patients who came with the clinical and radiological suspicion of lung disease were included in the study. Studying BAL in every case, Then Bronchial Biopsies, Microbiological tests and Biochemical tests like ADA were studied in many cases. Routine cytology and routine microbiology were studied. Results: Sensitivity (64.28%), Specificity (60.37%), Diagnostic Accuracy (62.40%), Positive and Negative predictive values (56.25%/68%) of BAL were found out. We also compared our results with Biopsies and other tests.

Conclusion: Broncheal lavage cytology is a good screening method for diagnosing lung diseases, as it is fairly sensitive, specific, when compared with biopsies that are gold standard Bal is easy tool, Quick, well tolerated.

Keywords: BAL: Bronchoalveolar Lavage, American Thoracic guidelines for clinical practice has given normal ranges of BAL