Background. Extrinsic allergic alveolitis (EAA) is usually established based on results of CT exam, immunology, and transbronchial lung biopsy (TBLB) during flexible bronchoscopy (FBS). As a rule, TBLB should be performed under fluoroscopy control, but it is not always possible, and in such situation efficacy of TBLB is controversial.
Aim. To investigate the effectivity of TBLB and bronchoalveloar lavage (BAL) during FBS in patients with newly diagnosed EAA.
Materials. 66 patients with EAA were enrolled into the study, all of them undergo CT of the chest with subsequent FBS with TBLB and BAL. We analyzed the diagnostic efficacy of TBLB upon histology and cytology, and diagnostic changes in BAL. Additionally, mean and median number of tissue samples, samples quality, frequency of pneumothorax and severe bleeding were analyzed.
Results. There were 37 females in the group, mean age for both sexes - 48.3 years, varied from 19 to 73 years. Mean disease duration from first symptoms/chest abnormalities was 87,1 weeks. Mean tissue samples number was 2,23, varied from 1 to 5, median 2. There were no complications. Lung tissue was observed in 42/66 cases (64,5%). Upon histology, granulomas and tissue infiltration were seen in 30 out of 66 patients (45,4%), additionally due to cytology granulomas were found in 4 cases, thus total efficacy of TBLB was 34/66 (51,5%). Among the rest 32 patients, diagnostically significant changes in BAL were found in 16 patients, so the total efficacy of TBLB plus BAL reached 50/66 (75,7%).
Conclusion. Bronchoscopy with TBLB and BAL even without fluoroscopy control is effective and safe way to establish the diagnosis of allergic alveolitis.