Bronchoscopic invasive diagnostic techniques in the cancer patient

The cancer patient often presents with fever and pulmonary infiltrates, in particular during the course of chemotherapy or after bone marrow transplan tation. In these conditions, specific diagnoses are mainly related to an in fective cause, but noninfectious processes, malignant or not, are also foun d alone or in combination with infection. Identification of the pulmonary p rocess can be achieved by bronchoscopic techniques, including bronchoalveol ar lavage (BAL) and transbronchial biopsy (TBB), BAL may help identify oppo rtunistic organisms but also bacterial pneumonia, provided quantitative cul tures are performed, and TBB has been shown to increase the diagnostic yiel d of BAL. These two procedures should then be combined, provided there is n o contraindication. (C) 2001 Lippincott Williams & Wilkins, Inc.