Use of bronchoalveolar lavage in the diagnosis of pulmonary diseases and its potential clinical-laboratory applications: a review

Uso do lavado broncoalveolar no diagnóstico de doenças pulmonares e suas potenciais aplicações clínico-laboratoriais: uma revisão

Abstract

Bronchoalveolar lavage (BAL) is a non-invasive bronchoscopic technique used to aspirate cells from the pulmonary interstitium, initially applied to detect neoplastic cells but later expanded for microbiological studies, leukocyte counts, molecular analyses, and immunophenotyping. This broader approach has linked BAL to the study of interstitial lung diseases (ILD). Despite its use since the 1970s, standardization of BAL cytopathological analysis is lacking, hindering its routine clinical application. The limited number of studies, particularly in Southern Hemisphere countries, reflects challenges in refining laboratory procedures and cytological findings. This article discusses the diagnostic potential of BAL when combined with clinical and radiological data. Integrating cytomorphologic findings with molecular techniques enhances its accuracy, particularly for cases with undefined etiopathogenesis, offering improved diagnostic and follow-up capabilities. The results make it clear that BALF cytology helps tell the difference between different types of ILDs. They also show that it is a useful tool for monitoring and diagnosing lung diseases.

Keywords:
cytology; cell differential count; diagnosis; interstitial lung disease; bronchoalveolar lavage