Diagnostic accuracy of bronchoalveolar lavage in lung lesions

  • Mridula D Shenoy Department of Pathology, K.S.Hegde Medical Academy, Karnataka (India)
  • Padma Shetty K Department of Pathology, K.S.Hegde Medical Academy, Karnataka (India)
  • Jayaprakash Shetty K Department of Pathology, K.S.Hegde Medical Academy, Karnataka (India)
Keywords: Bronchoalveolar lavage, bronchoscopic biopsy, lung carcinoma, sensitivity


Background: Suspicious lesions in the lung on radiology need further evaluation. Bronchoalveolar lavage (BAL) is a simple diagnostic procedure which can be done on an outpatient basis.  Cells obtained from bronchial and alveolar spaces can give a definite diagnosis in cases of malignancies and infections.Materials and methods: This is a prospective study done in Department of Pathology, K.S.Hegde Medical Academy between June 2014 and June 2015. 47 patients underwent BAL out of which 33 patients underwent simultaneous bronchoscopic biopsy. BAL fluid was centrifuged immediately and 4 smears were made from the sediment. Biopsy specimens were sent to the histopathology lab in 10% formalin.Results:  Of the 47 patients who underwent BAL, 18 patients had benign lesions and 22 cases were malignant. 7 cases were inadequate for diagnosis. Among the 47 patients only 33 patients had a conclusive histopathological diagnosis. Out of this 33 patients, 15 cases diagnosed as benign on BAL . however on correlation with histopathology 7 were found to be malignant. Malignant cases on BAL were proved by histopathological examination(HPE).  Overall efficacy for diagnosing malignant lesions in our study showed a sensitivity of 72%, specificity of 100%, positive predictive value of 100% and negative predictive value of 53.3%.Conclusion: BAL shows good sensitivity, specificity and accuracy in diagnosing lung lesions. Benign cases needs to be confirmed by biopsy. Thus a combination of both BAL and HPE is always beneficial. DOI: 10.21276/APALM.1525

Author Biography

Mridula D Shenoy, Department of Pathology, K.S.Hegde Medical Academy, Karnataka (India)


1. Eckardt J, Petersen HO, Hakami-Kermani A, Olsen KE, Jorgensen OD, Licht PB. Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed intrathoracic lesions. Interact Cardiovasc Thorac Surg. 2009 Aug 1;9(2):232–5.

2. Radha S, Afroz T, Prasad S, Ravindra N. Diagnostic utility of bronchoalveolar lavage. J Cytol. 2014 Jul;31(3):136

3. Naqvi H, Edhi M, Aslam M, Faridi N. Spectrum of intra-thoracic lesion detected by computed tomography guided fine needle aspiration biopsy.International Archives of Medicine. 2013; 6(4):1-5

4. Bhat N, Nazeir M, Bashir H, Bashir N, Farooq S, Fatima K, et al. Correlation of bronchial biopsy with bronchoalveolar lavage in lung malignancies. Int J Res Med Sci. 2016;428–35.

5. Gaur DS, Thapliyal NC, Kishore S, Pathak VP. Efficacy of bronchoalveolar lavage and bronchial brush cytology in diagnosing lung cancers. J Cytol. 2007;24:73-7.

6. Tuladhar A, Panth R, Joshi AR. Comparative analyses of cytohistologic techniques in diagnoses of lung lesions. Journal of Pathology of Nepal.2011;1:126 -30

7. Pirozynski M. Bronchoalveolar lavage in the diagnosis of peripheral primary lung cancer. Chest 1992;102(2):372-4.

8. Wongsurakiat P, Wongbunnate S, Dejsomritrutai W, Charoenratanakul S, Tscheikuna J, Youngchaiyud P, et al. Diagnostic value of bronchoalveolar lavage and post bronchoscopic sputum cytology in peripheral lung cancer. Respirology. 1998;3(2):131-7.
Original Article