CHEST-X-RAY IN COLLAGEN VASCULAR DISEASES - A COMPARISON OF CHEST-X-RAY WITH BRONCHOALVEOLAR LAVAGE AND TRANSBRONCHIAL FORCEPS BIOPSY

The diagnostic value of chest X-ray following the ILO standards was co mpared with bronchoalveolar lavage (BAL) and the histology of transbro nchial forceps biopsy in 83 patients with collagen vascular diseases. BAL in the middle lobe was considered abnormal in case of increased ce ll count per milliliter and/or lymphocytosis and/or neutrophil granulo cytosis and this was found in 32 out of 42 cases (76.2%) with, and in 33 of out 41 cases (80.5%) without abnormal radiological finding. Path ological changes in the histology were found in 14 out of 20 cases (70 .0%) with and in 40 out of 63 cases (63.5%) without abnormal chest X-r ay in the upper lobe from which the transbronchial forceps biopsy spec imens were obtained. In histological specimens obtained from transbron chial forceps biopsy, only fibrosis correlated with abnormal radiologi cal findings in this region. Other inflammatory processes defied predi ction by chest X-ray. This suggests that, regardless of chest X-ray fi ndings, BAL should be performed together with transbronchial forceps b iopsy for the histological examination of patients with collagen vascu lar diseases in which interstitial lung involvement is suspected.