Evidence map›Paper›PMID 39179174›Full record

ArticleChest2025

BAL Fluid Cellular Analysis and Radiologic Patterns in Patients With Fibrotic Interstitial Lung Disease.

Amanda Grant-Orser, Michael Asmussen, Daniel-Costin Marinescu, Cameron J Hague, Nestor L Muller, Darra T Murphy, Andrew Churg, Joanne L Wright, Amna Al-Arnawoot, Ana-Maria Bilawich and 32 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Amanda Grant-OrserDepartment of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Disease, University of Calgary, Calgary, AB, Canada. Electronic address: amanda.grant-orser@ahs.ca.
Michael AsmussenDepartment of Kinesiology, Vancouver Island University, Vancouver, BC, Canada.
Daniel-Costin MarinescuDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
Cameron J HagueDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Nestor L MullerDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Darra T MurphyDepartment of Radiology, St James' Hospital, Dublin, Ireland.
Andrew ChurgDepartment of Pathology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Joanne L WrightDepartment of Pathology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Amna Al-ArnawootDepartment of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, ON, Canada.
Ana-Maria BilawichDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Patrick BourgouinDepartment of Radiology, Radiation Oncology and Nuclear Medicine, University of Montreal, QC, Canada.
Gerard CoxDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Celine DurandCentre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Tracy ElliotDepartment of Radiology, University of Calgary, AB, Canada.
Jennifer EllisDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Jolene H FisherDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Derek FladelandDepartment of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada.
Gillian C GoobieDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada; Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Zachary GuentherDepartment of Radiology, University of Calgary, AB, Canada.
Ehsan HaiderDepartment of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, ON, Canada.
Nathan HamblyDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
James HuynhDepartment of Radiology, University of Calgary, AB, Canada.
Geoffrey KarjalaDepartment of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada.
Nasreen KhalilDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Martin KolbDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Jonathon LeipsicDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Stacey LokDepartment of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Sarah MacIsaacDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Micheal McInnisDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada; University Medical Imaging Toronto, Toronto General Hospital, Toronto, ON, Canada.
Helene ManganasDepartment of Medicine, Université de Montréal, Montreal, QC, Canada.
Veronica MarcouxDepartment of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
John MayoDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Julie MorissetDepartment of Medicine, Université de Montréal, Montreal, QC, Canada.
Ciaran ScallanDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Tony SedlicDepartment of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.
Shane ShaperaDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Kelly SunDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Victoria TanDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Alyson W WongDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
Boyang ZhengDivision of Rheumatology, McGill University, Montreal, QC, Canada.
Christopher J RyersonDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
Kerri A JohannsonDepartment of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Disease, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBAL cellular analysis is often recommended during the initial diagnostic evaluation of fibrotic interstitial lung disease (ILD). Despite recommendation for its use, between-center heterogeneity exists and supportive data concerning the clinical utility and correlation of BAL findings with radiologic features or patterns remain sparse. RESEARCH QUESTION: In patients with fibrotic ILD, are BAL findings associated with radiologic features, patterns, and clinical diagnoses? STUDY DESIGN AND

methodsPatients with fibrotic ILD who underwent BAL for diagnostic evaluation and who were enrolled in the prospective Canadian Registry for Pulmonary Fibrosis were re-reviewed in a standardized multidisciplinary discussion (MDD). BAL was categorized according to guideline-recommended thresholds, and using thresholds of lymphocytosis > 20% and neutrophils > 4.5%. High-resolution CT (HRCT) scans were scored (anonymized to clinical data) for specific features and percentage lung involvement. Radiologists classified HRCT scans according to guideline-defined patterns for idiopathic pulmonary fibrosis and fibrotic hypersensitivity pneumonitis; then, MDD diagnoses were assigned, considering all available data.

resultsBronchoscopy with cellular analysis was performed in 209 of 1,593 patients (13%). Lymphocyte % was weakly negatively correlated with total fibrosis % (r = -0.16, P = .023) but not statistically significantly correlated with ground glass opacity % (r = 0.01, P = .94). A mixed BAL pattern was the most frequent in all radiologic patterns (range, 45%-69%), with a minority classifiable according to BAL guidelines. BAL lymphocytosis appeared with similar frequency across HRCT patterns of fibrotic hypersensitivity pneumonitis (21%) and usual interstitial pneumonia (18%). Only 5% of patients with MDD-based fibrotic hypersensitivity pneumonitis had a guideline-defined isolated lymphocytosis > 15%.

interpretationBAL cellular analyses did not significantly correlate with radiologic features, guideline patterns, or MDD-based diagnoses. Ground glass opacities are often interpreted to represent pulmonary inflammation, but were not associated with BAL lymphocytosis in this cohort.

Indexed as

Bronchoalveolar Lavage FluidIdiopathic Pulmonary FibrosisLung Diseases, InterstitialAgedAlveolitis, Extrinsic AllergicBronchoscopyCanadaFemaleHumansMaleMiddle AgedProspective StudiesRegistriesTomography, X-Ray ComputedBALbronchoscopyguidelinesinterstitial lung diseaseradiologic patterns

Identifiers

PMID39179174
PMCPMC11752126

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.