Comparison of alveolar septal inflammation to bronchoalveolar lavage in interstitial lung diseases.
We analyzed transbronchial lung biopsy (TBLB) specimens by morphometry using a computer-aided graphic analyzer to quantify the severity of alveolar septal inflammation and investigated the correlation between the severity of inflammation and bronchoalveolar lavage fluid (BALF) lymphocyte content in various types of interstitial lung disease (ILD). Bronchoalveolar lavage was performed in the right S4 or S5 with 3 x 50 ml of sterile saline in 55 hospitalized patients with ILD between 1989 and 1993. Fluoroscopy-guided TBLB was then performed in the right S1, S2, S8, and S9. The severity of alveolar septal inflammation in TBLB specimens was quantified and expressed as the linear density of mononuclear cells infiltrating the alveolar septum. The severity of alveolar septal inflammation was not correlated with BALF lymphocyte content in the overall study populations (n = 55, p = 0.55), but was significantly correlated with BALF lymphocyte content in patients with hypersensitivity pneumonitis (n = 7, p = 0.021). No positive correlation was observed in patients with other types of ILD such as sarcoidosis (n = 17, p = 0.71), interstitial pneumonitis/fibrosis (n = 22, p = 0.98) or pneumoconiosis (n = 9, p = 0.48).
Nagata
N
N
Division of Respiratory Disease, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Takayama
K
K
Nikaido
Y
Y
Yokosaki
Y
Y
Kido
M
M
D000542:Alveolitis, Extrinsic Allergic / Q000473:pathology; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D006801:Humans; D007249:Inflammation / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology; D011009:Pneumoconiosis / Q000473:pathology; D011650:Pulmonary Alveoli / Q000473:pathology*