S157 A single centre retrospective study investigating the utility of bronchoalveolar lavage in the diagnosis of interstitial lung disease
S157 A single centre retrospective study investigating the utility of bronchoalveolar lavage in the diagnosis of interstitial lung disease
Introduction: bronchoalveolar lavage (BAL) differential cellular analysis may be a valuable tool in the diagnostic evaluation of patients with Interstitial Lung Disease (ILD), with international consensus guidelines typically recommending consideration in those without a definite Usual Interstitial Pneumonia pattern on HRCT, however the practical utility continues to be debated.1
Method: a single centre retrospective casenote review of patients undergoing BAL as part of ILD diagnostic workup.
Results: 36 patients underwent BAL between January 2022 and June 2025. 22 (61.1%) were female and median age was 66 years. 19 (52.7%) were ex-smokers with 13 (36.1%) non-smokers and 2 (5.5%) current smokers. The mean smoking pack year history was 21.3 years. BAL was generally well tolerated with no significant complications; 2 patients (5.5%) experienced minor complications with one experiencing hypoxia and subsequent early termination of the procedure; and one experiencing excessive coughing and discomfort.
The most frequent diagnoses included acute hypersensitivity pneumonitis (25%), fibrotic hypersensitivity pneumonitis (19.4%) and connective tissue disease related ILD (8.3%). 3 patients (8.3%) had a diagnosis of unclassifiable ILD following BAL and subsequent discussion in an ILD MDT.
31 (86.1%) of patients had their management influenced through BAL analysis. 11 patients (30.5%) were commenced on immunosuppression and 6 patients (16.6%) on anti-fibrotic medications.
Conclusion: bronchoalveolar lavage was safe and influenced MDT discussion and management in the majority of patients in this selected cohort. Systems standardising the integration of BAL into cytopathology departments and ILD MDTs might further increase utility and therefore aid in the diagnostic pathway of interstitial lung diseases.
Marguerie, S.E.
13db05ce-cd9b-4cca-8cb7-0cdb6d692260
Periwal, P.
f9b2948b-772e-4adc-8706-65e6f34af62b
Soe, W.
0674489f-0475-42d5-b221-2c78746fb182
Fletcher, Sophie
71599088-9df7-4d4a-8570-aef773ead0fe
1 November 2025
Marguerie, S.E.
13db05ce-cd9b-4cca-8cb7-0cdb6d692260
Periwal, P.
f9b2948b-772e-4adc-8706-65e6f34af62b
Soe, W.
0674489f-0475-42d5-b221-2c78746fb182
Fletcher, Sophie
71599088-9df7-4d4a-8570-aef773ead0fe
Marguerie, S.E., Periwal, P. and Soe, W.
,
et al.
(2025)
S157 A single centre retrospective study investigating the utility of bronchoalveolar lavage in the diagnosis of interstitial lung disease.
Thorax.
(doi:10.1136/thorax-2025-BTSabstracts.163).
Record type:
Meeting abstract
Abstract
Introduction: bronchoalveolar lavage (BAL) differential cellular analysis may be a valuable tool in the diagnostic evaluation of patients with Interstitial Lung Disease (ILD), with international consensus guidelines typically recommending consideration in those without a definite Usual Interstitial Pneumonia pattern on HRCT, however the practical utility continues to be debated.1
Method: a single centre retrospective casenote review of patients undergoing BAL as part of ILD diagnostic workup.
Results: 36 patients underwent BAL between January 2022 and June 2025. 22 (61.1%) were female and median age was 66 years. 19 (52.7%) were ex-smokers with 13 (36.1%) non-smokers and 2 (5.5%) current smokers. The mean smoking pack year history was 21.3 years. BAL was generally well tolerated with no significant complications; 2 patients (5.5%) experienced minor complications with one experiencing hypoxia and subsequent early termination of the procedure; and one experiencing excessive coughing and discomfort.
The most frequent diagnoses included acute hypersensitivity pneumonitis (25%), fibrotic hypersensitivity pneumonitis (19.4%) and connective tissue disease related ILD (8.3%). 3 patients (8.3%) had a diagnosis of unclassifiable ILD following BAL and subsequent discussion in an ILD MDT.
31 (86.1%) of patients had their management influenced through BAL analysis. 11 patients (30.5%) were commenced on immunosuppression and 6 patients (16.6%) on anti-fibrotic medications.
Conclusion: bronchoalveolar lavage was safe and influenced MDT discussion and management in the majority of patients in this selected cohort. Systems standardising the integration of BAL into cytopathology departments and ILD MDTs might further increase utility and therefore aid in the diagnostic pathway of interstitial lung diseases.
This record has no associated files available for download.
More information
Published date: 1 November 2025
Venue - Dates:
British Thoracic Society Winter Meeting 2025, , London, 2025-11-26 - 2025-11-28
Identifiers
Local EPrints ID: 510813
URI: http://eprints.soton.ac.uk/id/eprint/510813
ISSN: 0040-6376
PURE UUID: c474fa86-5f39-425e-8242-a5b864b5b344
Catalogue record
Date deposited: 22 Apr 2026 16:45
Last modified: 23 Apr 2026 02:22
Export record
Altmetrics
Contributors
Author:
S.E. Marguerie
Author:
P. Periwal
Author:
W. Soe
Author:
Sophie Fletcher
Corporate Author: et al.
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics