Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis

Özet

OBJECTIVES: The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with awide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis isaltered by clinicoradiological findings of patients with sarcoidosis.MATERIALS AND METHODS: The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatientclinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in thestudy. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis wererecorded. According to the diagnostic performance, the BALF results were grouped as “diagnostic” and “non-diagnostic,” and recordedparameters were compared between the groups.RESULTS: Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5–80), and the mean CD4/CD8was 5.5±4.7 (0.1–24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did notcorrelate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomographyscoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006).CONCLUSION: BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients withextrapulmonary involvement.