Fiberoptic bronchoscopy and bronchoalveolar lavage in patients with a haematological malignancy with bilateral pulmonary infiltrates

Introduction

Pulmonary infiltrates in patients with a haematological malignancy presents a special challenge for both diagnostic approach and clinical management.

Aim

To analyse the utility and impact of Fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in patients with haematological malignancy and bilateral pulmonary infiltrates.

Method

A FOB with BAL was performed using three 50 ml aliquot of 0.9% sterile saline solution and aspiration under continuos monitoring of the saturations, over a 24 month period.

Results

Data as median (range).

Discussion

We studied 35 patients with haematological malignancy with evolutive pneumonia despite treatment with appropriate empirical antimicrobial therapy. The overall diagnostic yield was 80%, which was identical in both neutropenic and non-neutropenic patients. This resulted in a change or rationalisation of antimicrobial therapy for both groups of patients.

Conclusion

FOB with a BAL is a beneficial investigative tool in patients with haematological malignancy with an evolutive pneumonia as manifested by bilateral pulmonary infiltrates.

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