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  • Title: [BAL from two different lung segments indicated by high resolution computed tomography (HRCT) in patients with sarcoidosis. I. Evaluation of alveolitis homogeneity and estimation of HRCT usefulness in selection of lung region for BAL].
    Author: Ziora D, Grzanka P, Mazur B, Niepsuj G, Oklek K.
    Journal: Pneumonol Alergol Pol; 1999; 67(9-10):422-34. PubMed ID: 10808386.
    Abstract:
    The aim of the study was: 1) to evaluate the homogeneity of alveolitis by estimation of lymphocytes subsets in double BAL (2 x 120 ml) from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement estimated by high resolution computed tomography (HRCT) 2) to examine the usefulness of HRCT as a guide method in selection the most reliable lung region for BAL. Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Twelve patients showed homogeneous distribution of HRCT changes (RD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. BAL lymphocytes subpopulations (CD3, CD19, NK, CD4, CD8, HLA-DR, CD25,) were estimated by flow-cytometry. Among patients from ND group in BAL from s.A we found the significantly higher (p < 0.01) mean total cell yield, the significantly higher (p < 0.05) mean values of % of lymphocytes (45.2 vs 36.8%) and CD4/CD8 ratio (5.3 vs 4.4) than in BAL from s.B. Also the mean values of absolute number of lymphocytes and lymphocytes CD4, HLA-DR, CD25 in ND group were significantly higher in BAL from s.A than in BAL from s.B. In RD group and in controls no significant differences between BAL findings from s.A and s.B were noticed. Our results suggest that: 1) alveolitis process is not fully homogeneous, it's intensity is greater in upper lobes with most extensive involvement of HRCT changes 2) HRCT can serve as a useful method for selection the most reliable lung region for BAL.
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