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Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias.
Respir Med. 2007 Mar; 101(3):655-60.RM

Abstract

The purpose of this study was to assess the role of bronchoalveolar lavage (BAL) in differentiating usual interstitial pneumonia (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 male) 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.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongdaemun Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16919929

Citation

Ryu, Yon Ju, et al. "Bronchoalveolar Lavage in Fibrotic Idiopathic Interstitial Pneumonias." Respiratory Medicine, vol. 101, no. 3, 2007, pp. 655-60.
Ryu YJ, Chung MP, Han J, et al. Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias. Respir Med. 2007;101(3):655-60.
Ryu, Y. J., Chung, M. P., Han, J., Kim, T. S., Lee, K. S., Chun, E. M., Kyung, S. Y., Jeong, S. H., Colby, T. V., Kim, H., & Kwon, O. J. (2007). Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias. Respiratory Medicine, 101(3), 655-60.
Ryu YJ, et al. Bronchoalveolar Lavage in Fibrotic Idiopathic Interstitial Pneumonias. Respir Med. 2007;101(3):655-60. PubMed PMID: 16919929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias. AU - Ryu,Yon Ju, AU - Chung,Man Pyo, AU - Han,Joungho, AU - Kim,Tae Sung, AU - Lee,Kyung Soo, AU - Chun,Eun-Mi, AU - Kyung,Sun Young, AU - Jeong,Sung Hwan, AU - Colby,Thomas V, AU - Kim,Hojoong, AU - Kwon,O Jung, Y1 - 2006/08/21/ PY - 2006/03/06/received PY - 2006/05/04/revised PY - 2006/06/03/accepted PY - 2006/8/22/pubmed PY - 2007/4/24/medline PY - 2006/8/22/entrez SP - 655 EP - 60 JF - Respiratory medicine JO - Respir Med VL - 101 IS - 3 N2 - The purpose of this study was to assess the role of bronchoalveolar lavage (BAL) in differentiating usual interstitial pneumonia (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 male) 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. SN - 0954-6111 UR - https://www.unboundmedicine.com/medline/citation/16919929/Bronchoalveolar_lavage_in_fibrotic_idiopathic_interstitial_pneumonias_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(06)00285-X DB - PRIME DP - Unbound Medicine ER -