The diagnosis of cystic lung diseases

A role for bronchoalveolar lavage and transbronchial biospy?

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Pulmonary Langerhans' cell histiocytosis (PLCH) and lymphangioleiomyomatosis (LAM) are two rare cystic lung diseases of unknown aetiology and different pathogenesis. Although the diagnosis can be strongly suspected on the basis of the medical history and clinical and radiological features, at times a pathological confirmation of the diagnosis is necessary. Surgical lung biopsy is considered the gold standard in the diagnosis of both LAM and PLCH. However, bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) are less invasive procedures that can be useful in diagnosis. BAL has a high specificity but low sensitivity for PLCH, and in an appropriate clinical context it can be used to establish the diagnosis. However, even if a high percentage of pigment-laden macrophages are found in the BAL fluid of patients with LAM, no BAL findings are considered suggestive for the disease. TBB shows a low diagnostic yield (10-40%) in PLCH because of the small amount of tissue obtained and the patchy nature of the disease, although it may be of more use in LAM.

Original languageEnglish
JournalRespiratory Medicine
Volume104
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Jul 2010

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Bronchoalveolar Lavage
Lymphangioleiomyomatosis
Langerhans Cell Histiocytosis
Lung
Biopsy
Bronchoalveolar Lavage Fluid
Cystic Disease Of Lung
Macrophages
Sensitivity and Specificity

Keywords

  • Bronchoalveolar lavage
  • Lymphangioleiomyomatosis
  • Pulmonary Langerhans' cell histiocytosis
  • Transbronchial biopsy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

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title = "The diagnosis of cystic lung diseases: A role for bronchoalveolar lavage and transbronchial biospy?",
abstract = "Pulmonary Langerhans' cell histiocytosis (PLCH) and lymphangioleiomyomatosis (LAM) are two rare cystic lung diseases of unknown aetiology and different pathogenesis. Although the diagnosis can be strongly suspected on the basis of the medical history and clinical and radiological features, at times a pathological confirmation of the diagnosis is necessary. Surgical lung biopsy is considered the gold standard in the diagnosis of both LAM and PLCH. However, bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) are less invasive procedures that can be useful in diagnosis. BAL has a high specificity but low sensitivity for PLCH, and in an appropriate clinical context it can be used to establish the diagnosis. However, even if a high percentage of pigment-laden macrophages are found in the BAL fluid of patients with LAM, no BAL findings are considered suggestive for the disease. TBB shows a low diagnostic yield (10-40{\%}) in PLCH because of the small amount of tissue obtained and the patchy nature of the disease, although it may be of more use in LAM.",
keywords = "Bronchoalveolar lavage, Lymphangioleiomyomatosis, Pulmonary Langerhans' cell histiocytosis, Transbronchial biopsy",
author = "Olga Torre and Sergio Harari",
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AU - Torre, Olga

AU - Harari, Sergio

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N2 - Pulmonary Langerhans' cell histiocytosis (PLCH) and lymphangioleiomyomatosis (LAM) are two rare cystic lung diseases of unknown aetiology and different pathogenesis. Although the diagnosis can be strongly suspected on the basis of the medical history and clinical and radiological features, at times a pathological confirmation of the diagnosis is necessary. Surgical lung biopsy is considered the gold standard in the diagnosis of both LAM and PLCH. However, bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) are less invasive procedures that can be useful in diagnosis. BAL has a high specificity but low sensitivity for PLCH, and in an appropriate clinical context it can be used to establish the diagnosis. However, even if a high percentage of pigment-laden macrophages are found in the BAL fluid of patients with LAM, no BAL findings are considered suggestive for the disease. TBB shows a low diagnostic yield (10-40%) in PLCH because of the small amount of tissue obtained and the patchy nature of the disease, although it may be of more use in LAM.

AB - Pulmonary Langerhans' cell histiocytosis (PLCH) and lymphangioleiomyomatosis (LAM) are two rare cystic lung diseases of unknown aetiology and different pathogenesis. Although the diagnosis can be strongly suspected on the basis of the medical history and clinical and radiological features, at times a pathological confirmation of the diagnosis is necessary. Surgical lung biopsy is considered the gold standard in the diagnosis of both LAM and PLCH. However, bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) are less invasive procedures that can be useful in diagnosis. BAL has a high specificity but low sensitivity for PLCH, and in an appropriate clinical context it can be used to establish the diagnosis. However, even if a high percentage of pigment-laden macrophages are found in the BAL fluid of patients with LAM, no BAL findings are considered suggestive for the disease. TBB shows a low diagnostic yield (10-40%) in PLCH because of the small amount of tissue obtained and the patchy nature of the disease, although it may be of more use in LAM.

KW - Bronchoalveolar lavage

KW - Lymphangioleiomyomatosis

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KW - Transbronchial biopsy

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