Source: Annual Congress 2001 - Interstitial lung disease: BAL in diagnosis and management
Disease area: Interstitial lung diseases

Abstract

Aim: To define and compare the bronchoalveolar lavage (BAL) differential cell count findings in open lung biopsy proven idiopathic non specific interstitial pneumonia (NSIP) and idiopathic usual interstitial pneumonia (UIP). Methods: Retrospective analysis of the BAL findings and open lung biopsies in Idiopathic Pulmonary Fibrosis (IPF) patients seen at the Royal Brompton hospital between 1979 and 1999. The open lung biopsies were reclassified as either UIP or NSIP as per the Katzenstein & Myers classification. Results: Sixty-nine patients had both an open lung biopsy and BAL. Thirty biopsies were reclassified as NSIP (2 NSIP1, 15 NSIP2, 13 NSIP3) and 39 as UIP. The mean BAL counts in NSIP were lymphocytes 7.9, neutrophils 14.8 and eosinophils 8.2. Among the NSIP patients 13% had normal BAL cell count, 13% had lymphocytosis (>14%), 80% had neutrophilia (>4%) and 67% had eosinophilia (>3%). The mean BAL counts in UIP were lymphocytes 9.1, neutrophils 17.7 and eosinophils 6.9. Among the UIP patients 5% had normal BAL cell count, 20% had lymphocytosis, 82% had neutrophilia and 59% had eosinophilia. There was no statistically significant difference between the BAL cell counts of the two groups. FVC levels were significantly lower in UIP (M ±] SD: 72.7 ±] 19.3) than in NSIP (85.3 ±] 17.1) (p<0.05). However, BAL cell differential counts did not differ between UIP and NSIP, after adjustment for FVC and Dlco levels. Conclusions: BAL cell differential counts do not differ between UIP and NSIP, in patients presenting with the clinical features of IPF.

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Citations should be made in the following way:
S. Veeraraghavan, A. U. Wells, P. Pantelidis, P. Haslam, A. Nicholson, T. Colby, R. M. du Bois (London, United Kingdom). Bronchoalveolar lavage findings in idiopathic NSIP and UIP. Eur Respir J 2001; 16: Suppl. 31, 3414

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