Bronchoalveolar Lavage in Malignancy

Venerino Poletti; Giovanni Poletti; Bruno Murer; Luca Saragoni; Marco Chilosi

doi:10.1055/s-2007-991526

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2007; 28(5): 534-545
DOI: 10.1055/s-2007-991526

Bronchoalveolar Lavage in Malignancy

Venerino Poletti¹ , Giovanni Poletti² , Bruno Murer³ , Luca Saragoni⁴ , Marco Chilosi⁵

¹Department of Thoracic Diseases, Ospedale GB Morgagni, Forli, Italy
²Department of Clinical Pathology, Ospedale Santa Maria delle Croci, Ravenna, Italy
³Department of Surgical Pathology, Ospedale Umberto I, Mestre, Italy
⁴Department of Anatomic Pathology, Ospedale GB Morgagni, Forlì, Italy
⁵Department of Pathology, University of Verona, Verona, Italy

Abstract

ABSTRACT

Bronchoalveolar lavage is a useful diagnostic tool in diffuse or disseminated lung malignancies that do not involve the bronchial structures visible by endoscopy. The neoplastic histotype and the intraparenchymal neoplastic growth pattern are good predictors for diagnostic yield; adenocarcinoma, and tumors with lymphangitic or lepidic growth patterns are more easily diagnosed by bronchoalveolar lavage; in these cases the diagnostic yield reported is higher than 80%. In hematologic malignancies the diagnostic yield is quite good in secondary diffuse indolent B cell lymphomas and in primary B cell lymphomas of mucosa-associated lymphoid tissue (MALT) type but low in Hodgkin disease. Morphological analysis may be implemented by immunocytochemical or molecular tests to identify the cell lineage and the presence of monoclonality. Disorders in which bronchioloalveolar cell hyperplasia/dysplasia is a significant morphological component may have cytological features in bronchoalveolar lavage fluid that mimic lung neoplasms: acute respiratory distress syndrome (ARDS), acute interstitial pneumonitis (AIP), and acute exacerbation of idiopathic pulmonary fibrosis are the most important clinical entities in this group.

KEYWORDS

Bronchoalveolar lavage - bronchioloalveolar cell carcinoma - lymphoproliferative lung disorders - carcinomatous lymphangitis - lung neoplasms

Full Text

References

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Venerino PolettiM.D.

Department of Thoracic Diseases, Ospedale GB Morgagni

Via C Forlanini 34, 47100 Forlì, Italy

Email: v.poletti@ausl.fo.it