The importance of bronchoalveolar lavage findings in diagnosis and their relationship with radiological findings in pediatric interstitial lung diseases: Turkey chILD National Registry Cohort Study

Abstract

Bronchoscopy and cell count analysis in interstitial lung diseases (ILD) provide valuable information at the alveolar level. Computed tomography (CT) is considered the gold standard for characterizing ILD. The aim of this study is to evaluate the diagnostic significance of bronchoalveolar lavage (BAL) findings and their relationship with radiological findings in ILD patients from the National Registry System. Materials and Methods: Data from patients registered in the National Registry System between 2022 and 2023 were retrospectively reviewed. Disease subgroups, serological and radiological findings, and BAL results were analyzed. Results: A total of 599 patients were registered, of which 255 had undergone bronchoscopy and chest CT. When disease diagnoses were categorized, the most frequent diagnosis was B2 (immune function presumed normal in the host) in 70 (27.4%) patients. The most common radiological finding was ground-glass opacity, seen in 151 (61.4%) cases. Specific diagnoses included pulmonary alveolar proteinosis (PAS+ in 6 [2.4%] patients. When the relationship between BAL findings and radiological findings was assessed, a significant association was found between increased levels of hemosiderin-laden macrophages and interstitial thickening. A significant correlation was also observed between interstitial thickening and between focal consolidations. Conclusion: The cytological evaluation of BAL, when used in conjunction with chest CT, can provide valuable diagnostic insights in ILD and may reduce the need for invasive procedures such as surgical lung biopsy.