• Ayesha Ahmed
  • Sajjad Ahmed


Background: The objectives of this study were to compare bronchoalveolar lavage (BAL) cytology and transbronchial biopsy in the diagnosis of carcinoma lung and to determine accuracy of BAL cytology using histopathologic examination of transbronchial biopsy as gold standard at our center. Methods: This study was carried out at Department of Histopathology, Ayub Medical College, Abbottabad, from 1-9-2000 to 28-2-2003. BAL fluid and bronchial biopsy were received and processed simultaneously. Four cytology and a set of histopathology slides were prepared. These were screened and diagnosis recorded. Sensitivity, Specificity, False Positive, False Negative, Positive predictive value and Negative predictive value of BAL cytology were determined using histopathology of transbronchial biopsy as gold standard. Results: We found the sensitivity of BAL cytology to be 93.44% as compared with transbronchial biopsy. The specificity was 100%. There was no false positive while false negative results were 6.55%. The positive predictive value was 100%, while the negative predictive value was 75%. The overall diagnostic efficacy of BAL cytology was 94.52%. Conclusion: BAL cytology is a highly sensitive and specific test for diagnosis of carcinoma lung. It can be used as a quick and reliable diagnostic method for diagnosis of lung malignancy.Keywords: bronchoalveolar lavage, cytology, lung, carcinoma, biopsy 


Jaffarey NA, Zaidi SHM. Cancer in Pakistan. J Pak Med Assoc 1987;37:178-83.

Tanwani AK, Haque AU. Correlation of bronchial brushing with biopsy in lung lesions. Pakistan J Med Res 2000;39(3):115-120.

Young JA. Techniques in pulmonary cytopathology. ACP broadsgheet 140. J Clin Pathol 1993;46:589-95.

Rennard SI. Bronchoalveolar lavage in the assessment of primary and metastatic lung cancer. Z Erkr Atmungsorgane 1981;157(1):34-40

Dudgeon LS, Barret NR. The examination of fresh tissues by the wet film method. Br j Surg 1934;22:4-22.

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

Tang CC, Hsiao CJ, Chen H, Wang CH, Lin HC, Yu CT, Kuo HP. Value of bronchoalveolar lavage combined with transbronchial lung biopsy in the diagnosis of peripheral lung cancer. Changgeng Yi Xue Za Zhi 2000 Nov;23(11):695-700

Linder J, Radio SJ, Robbins RA, Ghafouri M, Rennard SI. Bronchoalveolar lavage in the cytologic diagnosis of carcinoma of the lung. Arch Pathol Lab Med 1989;113(4):333-6

Cotran RS, Kumar V, Collins T. The Lung. In: Pathologic basis of disease: 7th edition. Philadelphia. WB Saunders & Company. PP

Kuhn C, Askin FB. Lung and Mediastinum. Andersons Pathology. Philadelphia. WB Saunders.

Piaton E, Grillet-Ravigneaux MH, Saugier B, Pellet H. Prospective study of combined use of bronchial aspirates and biopsy specimens in diagnosis and typing of centrally located lung tumours. BMJ 1995;310(6980):624-7

Kopinski P, Chlap Z, Owsinski J, Soja J, Stankiewicz Z, Biernat-Silczuk M, Czarnobilska E, Czunko P. Principles of optimal preparation of material from bronchoalveolar lavage (BAL)for cytoimmunologic examinations in interstitial lung diseases. Przegl Lek 2000;57(9):489-92

Yamamoto S. Diagnostic value of bronchoalveolar lavage(BAL)--the comparative study with open lung biopsy and BAL. Rinsho Byori 1994;42(3):265-70

Niklinski J, Chyczewski L, Chyczewska E, Laudanski J, Furman M. A correlative study of bronchial cytology, bronchoalveolar lavage (BAL) and serum tumor markers in the diagnosis of lung carcinoma. Folia Histochem Cytobiol 1993;31(4):211-3

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

Ovchinnikov A, Chernishova V. Different methods of performing diagnostic bronchoalveolar lavage in patients suffering from diffuse lung diseases. Z Erkr Atmungsorgane 1987;169(3):245-9

Fend F, Mikuz G, Ott G, Rothmund J. Diagnostic value of combined bronchoalveolar lavage and transbronchial lung biopsy. Pathol Res Pract 1989 Mar;184(3):312-7

Debeljak A, Mermolja M, Sorli J, Zupancic M, Zorman M, Remskar J. Bronchoalveolar lavage in the diagnosis of peripheral primary and secondary malignant lung tumors. Respiration 1994;61(4):226-30

de Gracia J, Bravo C, Miravitlles M, Tallada N, Orriols R, Bellmunt J, Vendrell M, Morell F. Diagnostic value of bronchoalveolar lavage in peripheral lung cancer. Am Rev Respir Dis 1993 Mar;147(3):649-52

Lachman MF, Schofield K, Cellura K. Bronchoscopic diagnosis of malignancy in the lower airway. A cytologic review. Acta Cytol 1995 Nov-Dec;39(6):1148-51

Rennard SI. Bronchoalveolar lavage in the diagnosis of cancer. Lung 1990;168:1035-40

Saenghirunvattana S, Charoenpan P, Kiatboonsri S, Aeursudkij B, Srivanaboon S, Rochanawutanon M. Final diagnosis of "suspicious for malignancy" from bronchial washing cytology. J Med Assoc Thai 1991 Apr;74(4):196-9

Khalid M, Rasul S, Iqbal Z. Fibroptic bronchoscopy. Role in the diagnosis of bronchogenic carcinoma. Abstracts of international conference of tubercul;osis and chest disease held at Lahore 8-11th March 1998;65.

Poletti V, Romagna M, Allen KA, Gasponi A, Spiga L. Bronchoalveolar lavage in the diagnosis of disseminated lung tumors. Acta Cytol 1995 May-Jun;39(3):472-7

Radio SJ, Rennard SI, Kessinger A, Vaughan WP, Linder J. Breast carcinoma in bronchoalveolar lavage. A cytologic and immunocytochemical study. Arch Pathol Lab Med 1989 Apr;113(4):333-6

Levy H, Horak DA, Lewis MI. The value of bronchial washings and bronchoalveolar lavage in the diagnosis of lymphangitic carcinomatosis. Chest 1988 ; 94 (5) : 1028 -30

Most read articles by the same author(s)

1 2 > >>