European Journal of Molecular & Clinical Medicine

Background: Lung pathology is the leading cause of death in developed countries and is increasing at alarming rates in developing countries. Flexible fiberoptic bronchoscope revolutionized respiratory cytology as techniques such as bronchial brushing (BB), bronchoalveolar lavage (BAL), and bronchial biopsy became more easy, accessible, and popular. Fine needle aspiration cytology (FNAC) has proved to be the most helpful method for the diagnosis of lung tumors.The present study was conducted to compare Bronchoalveolar Lavage and Transbronchial Lung Biopsy in Various Lung Pathologies.

Background: Mycobacterium tuberculosis complex is the causative organism of tuberculosis, it is a major health problem throughout the world. In developing countries like India, almost 25% of adult deaths which are avoidable are caused by it.
Around 22-61% of Cases have smear negative but culture positive state where clinical profile and radiological lesions suggest diagnosis of pulmonary tuberculosis, then initiation of anti-tubercular drugs is not advisable without meticulous search for tubercular bacilli.
Gold standard for diagnosis of tuberculosis is culture of sputum, but it takes long time( 45 days ) to perform.
Aim: Evaluation of bronchoalveolar lavage fluid in clinically and radiologically suspected cases of sputum smear negative pulmonary tuberculosis.
Methodology: In our observational, cross sectional study done in the Department of Respiratory Medicine, NIMS involving all the patients attending indoor and outdoor services in one year period from January 2019 to June 2020, we tried to access the diagnostic yield of bronchoalveolar lavage fluid in clinically and radiologically suspected cases of sputum smear negative pulmonary tuberculosis. Then the Broncholaveolar Lavage (BAL)  fluid  specimen  was  sent  for  smear  for  AFB, CBNAAT and  BACTEC  culture  for  Mycobacterium tuberculosis.
Result: In this study, pulmonary infiltrate (54.2 %) was most common radiological finding in their chest x-ray, followed by cavity (31.2%). 17 patients had nodular shadow (8.9%) and only 11 patients had miliary pattern (5.7%). Out of 190 cases, 156 patients had unilateral involvement of lung (82.2%) and only 34 cases had bilateral involvement (17.8%). Most of the patients had right upper zone (58.4%)  involvement followed by left upper zone (12.2%) with involvement of lower lung field in only 4.2%.
Conclusion: To conclude bronchoalveolar lavage obtained by fiber optic bronchoscopy is a relatively safe and useful procedure for diagnosis of suspected pulmonary tuberculosis cases when smears of these patients does not reveal mycobacterium tuberculosis.

Background: High-resolution computed tomography (HRCT) is more sensitive than plain chest radiograph in distinction of ILD (affectability more conspicuous than 90%) and the image illustration of parenchymal peculiarities on HRCT consistently propose a particular course of action of scientific abnormalities.
Aim: To assess the usefulness of HRCT chest and flexible optic bronchoscopy concerning Bronchoalveolar lavage cellular analysis in the diagnosis of interstitial lung disease. Materials and Methods: A prospective observational study was conducted at tertiary hospital in south India. 50 patients who are suspected to have interstitial lung infection by clinical assessment and history with manifestations and signs are assessed with HRCT chest and HRCT affirmed patients are exposed to fiber optic bronchoscopy and bronchoalveolar lavage is performed and their cytological profiles are investigated.
Results: The mean age of the patients was 50.18 years (SD ±14.3), with an age range from 18 to 70years and most of the study subjects were males. Dyspnoea was the most common presenting symptom (90% of patients), followed by cough (84%) and least is dysphagia (6%). In one young female, a cystic pattern was seen on HRCT with multiple diffuse thin-walled cysts which made us to make a diagnosis of LAM.
Conclusion:Thus, HRCT and BAL when combined, help us in making a confident diagnosis of ILD, obviating the need of a lung biopsy which is not feasible in routine practice due to lack of expertise, facilities and patient reluctance in undergoing a biopsy procedure.