Bronchopulmonary Lavage in Normal Subjects and Patients with Obstructive Lung Disease

Abstract

Saline lavage was carried out on 7 normal subjects, 4 patients with obstructive lung disease and 1 patient with a diffuse nodular infiltrate. The technique consisted of flushing 3 100 ml aliquots of saline in and out of an isolated bronchopulmonary segment through a cuffed catheter. In normal subjects most of the lavage fluid was recovered and the lung cleared rapidly. In the patients with obstructive lung disease no lavage fluid could be recovered and an infiltrate persisted for 1 to 4 days in the lavaged segment. The lavage sediment, approximately 0.3 ml, consisted of an upper amorphous white layer and a lower cellular brown layer. The white layer was found to be a lipoprotein similar in composition to alveolar lipids. The brown layer consisted of alveolar lining cells. In the subject with the nodular infiltrate the sediment contained organisms consistent with Histoplasma capsulatum. The technique described appears to be a useful method for obtaining alveolar lining cells and a lipoprotein material, presumably alveolar lining material, in patients without obstructive airway disease. In addition, the technique may prove useful in diagnosis of various lung diseases.