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Ann Thorac Surg 1986;41:318-321
© 1986 The Society of Thoracic Surgeons

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Articles

Diagnosis for Interstitial Lung Disease in Patients with Acquired Immunodeficiency Syndrome (AIDS): A Prospective Comparison of Bronchial Washing, Alveolar Lavage, Transbronchial Lung Biopsy, and Open-Lung Biopsy

From the Department of Thoracic Surgery, University of Texas System Cancer Center, M.D. Anderson Hospital and Tumor Institute, Houston, TX

Accepted for publication July 9, 1985.

^* Address reprint requests to Dr. McKenna, Department of Thoracic Surgery, UT M.D. Anderson Hospital, 6723 Bertner Avenue, Houston, TX 77030

This study was undertaken to compare prospectively the diagnostic yield of the various bronchoscopic techniques with that of open-lung biopsy for interstitial lung disease in patients with acquired immunodeficiency syndrome (AIDS). Under general anesthesia, 15 patients sequentially underwent bronchial washing, transbronchial lung biopsy, alveolar lavage, and open-lung biopsy in the same segment of lung. Of nine patients with Pneumocystis carinii, seven were diagnosed by means of the transbronchial lung biopsy, eight by the open-lung biopsy, and all nine by alveolar lavage. Of the six patients with cytomegalovirus, five were diagnosed by the open-lung biopsy, five by the transbronchial lung biopsy, and three by alveolar lavage. The sensitivities of the procedures for identifying infection were washings (15%), transbronchial lung biopsy (50%), alveolar lavage (73%), and open-lung biopsy (88%). Combined, transbronchial lung biopsy and alveolar lavage showed a diagnostic yield (85%) for infections comparable to that of open-lung biopsy (88%), thereby obviating the need for open-lung biopsy for such diagnoses. However, open-lung biopsy was the only procedure that diagnosed Kaposi's sarcoma in lung.

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