Cellular pattern of bronchoalveolar lavage fluid in suspected cases of interstitial lung diseases

: Bronchoalveolar lavage, a safe and less invasive treatment, is used as an auxiliary diagnostic tool when lung biopsy and radiologic imaging are insufficient in providing information to diagnosis interstitial lung disease (ILD). The aim is to analyse differential count in Bronchoalveolar lavage (BAL) fluid in suspected cases of interstitial lung diseases and hence guiding clinicians for better management of the patient. A cross-sectional study was performed for one year. Bronchoalveolar lavage fluid was recovered from thirty suspected cases of ILD, and sent to the cytopathology department where at least 400 cells were microscopically analyzed on centrifuged slides. Among 30 suspected casesNeutrophilic cellular pattern was predominantly observed in six cases ofUsual Interstitial Pneumonia, five cases of Non-specific Interstitial Pneumonia and four cases of Cryptogenic organizing pneumonia. Similarly, lymphocytic cellular pattern was predominant in four cases of Sarcoidosis. Among four cases each of Hypersensitivity Pneumonitis and Granulomatous Polyangitis, different cellular pattern was discerned in each case. Acute interstitial pneumonia and silicosis each had one case exhibiting mixed cellular pattern and increased macrophages respectively. Because subcategorization was not possible, 1 case was assigned an ILD-post-COVID status that showed Normal cellullar pattern. When treating suspected cases of ILDs, BAL fluid analysis may be essential in helping the physician confirm a diagnosis or narrow the differential diagnosis. In addition, BAL helps to predict whether a disease is acute or chronic and provide details on the condition of superadded infections to help with proper treatment.