Diagnostic yield of bronchoalveolar lavage in pneumonitis occurring after allogeneic bone marrow transplantation

Am Rev Respir Dis. 1985 Nov;132(5):1118-23. doi: 10.1164/arrd.1985.132.5.1118.


Fifty-two bronchoalveolar lavages (BAL) were performed in order to investigate 46 episodes of pneumonitis that occurred after allogeneic bone-marrow transplantation. No complications have been attributed to this procedure. A specific etiologic diagnosis was obtained in 24 of 46 episodes (52%) by 26 of 52 BAL (50%). Cytomegalovirus (CMV), diagnosed by the presence of typical inclusions, was the pathogen most frequently identified by BAL (13 of 46 episodes) and was associated with other causes of pneumonia in 4 patients. The other causes of pneumonitis diagnosed by BAL were: giant-cell pneumonia: 1, aspergillosis alone: 3, Pneumocystis carinii: 1, Hemophilus influenzae: 3, isolated pulmonary hemorrhage: 3. One false negative (aspergillosis, n = 1) was diagnosed at autopsy. The overall mortality rate of these episodes was 24%. Thus, BAL appears to be a rapid and reproducible diagnostic method for monitoring pneumonitis in grafted patients, particularly CMV pneumonitis, and may avoid the need for surgical biopsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Bone Marrow Transplantation*
  • Bronchi / pathology*
  • Child
  • Cytomegalovirus / isolation & purification
  • Female
  • Humans
  • Lung / pathology
  • Male
  • Middle Aged
  • Pneumonia / diagnosis*
  • Pneumonia / etiology
  • Pulmonary Alveoli / microbiology
  • Pulmonary Alveoli / pathology*
  • Therapeutic Irrigation