{"id":27771,"date":"2025-04-15T04:51:00","date_gmt":"2025-04-14T20:51:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27771"},"modified":"2025-04-15T05:50:09","modified_gmt":"2025-04-14T21:50:09","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%82%ba%e9%97%b4%e8%b4%a8%e7%ba%a4%e7%bb%b4%e5%8c%96%e6%82%a3%e8%80%85%e7%9a%84balf%e7%bb%86%e8%83%9e%e5%ad%a6%e5%88%86%e6%9e%90%e4%b8%8e%e5%bd%b1","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27771","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u80ba\u95f4\u8d28\u7ea4\u7ef4\u5316\u60a3\u8005\u7684BALF\u7ec6\u80de\u5b66\u5206\u6790\u4e0e\u5f71\u50cf\u5b66\u5206\u578b"},"content":{"rendered":"\n

Diffuse Lung Disease: Original Research<\/p>\n\n\n\n

BAL Fluid Cellular Analysis and Radiologic Patterns in Patients With Fibrotic Interstitial Lung Disease<\/h1>\n\n\n\n

Amanda\u00a0Grant-Orser,\u00a0Michael\u00a0Asmussen,\u00a0Daniel-Costin\u00a0Marinescu, et al<\/h3>\n\n\n\n

Chest 2025; 167: 172-182<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1016\/j.chest.2024.07.166<\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

BAL cellular analysis is often recommended during the initial diagnostic evaluation of fibrotic interstitial lung disease (ILD). Despite recommendation for its use, between-center heterogeneity exists and supportive data concerning the clinical utility and correlation of BAL findings with radiologic features or patterns remain sparse.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

In patients with fibrotic ILD, are BAL findings associated with radiologic features, patterns, and clinical diagnoses?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

Patients with fibrotic ILD who underwent BAL for diagnostic evaluation and who were enrolled in the prospective Canadian Registry for Pulmonary Fibrosis were re-reviewed in a standardized multidisciplinary discussion (MDD). BAL was categorized according to guideline-recommended thresholds, and using thresholds of lymphocytosis > 20% and neutrophils > 4.5%. High-resolution CT (HRCT) scans were scored (anonymized to clinical data) for specific features and percentage lung involvement. Radiologists classified HRCT scans according to guideline-defined patterns for idiopathic pulmonary fibrosis and fibrotic hypersensitivity pneumonitis; then, MDD diagnoses were assigned, considering all available data.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Bronchoscopy with cellular analysis was performed in 209 of 1,593 patients (13%). Lymphocyte %\u00a0was weakly negatively correlated with total fibrosis %\u00a0(r<\/em>\u00a0= \u20130.16,\u00a0P<\/em>\u00a0= .023) but not statistically significantly correlated with ground glass opacity %\u00a0(r<\/em>\u00a0= 0.01,\u00a0P<\/em>\u00a0= .94). A mixed BAL pattern was the most frequent in all radiologic patterns (range, 45%-69%), with a minority classifiable according to BAL guidelines. BAL lymphocytosis appeared with similar frequency across HRCT patterns of fibrotic hypersensitivity pneumonitis (21%) and usual interstitial pneumonia (18%). Only 5%\u00a0of patients with MDD-based fibrotic hypersensitivity pneumonitis had a guideline-defined isolated lymphocytosis > 15%.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

BAL cellular analyses did not significantly correlate with radiologic features, guideline patterns, or MDD-based diagnoses. Ground glass opacities are often interpreted to represent pulmonary inflammation, but were not associated with BAL lymphocytosis in this cohort.<\/p>\n","protected":false},"excerpt":{"rendered":"

Diffuse Lung Disease: Original Research BAL Fluid Cellu […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27771"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27771"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27771\/revisions"}],"predecessor-version":[{"id":27772,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27771\/revisions\/27772"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27771"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27771"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}