Application of Fibrotic Bronchoscopy in the Diagnosis of Pulmonary Diffuse Infiltration Following Bone Marrow Transplantation

In order to evaluate the diagnostic value of fibrotic bronchoscopy(FB) in the pulmonary infiltration following bone marrow transplantation(BMT),18 patients with pulmonary complications after BMT from November 2003 to March 2006 were performed with FB. Bronchoalveolar lavage(BAL) and brushing were performed in patients who had received short-term empirical therapy without good response, and transbronchial lung biopsy(TBLB) was carried out in 3 cases.The results showed that 9 out of 10 cases with pulmonary infection,including bacterial pneumonia(n=3),aspergillosis(n=2),pneumocystis carinii pneumonia(n=3) and viral infection(n=1) were diagnosised by using FB.One case was diagnosed as tuberculosis after open lung biopsy following negative results from twice BAL.2 out of 8 cases were diagnosed by TBLB as noninfectious pulmonary complications.In conclusion,FB,especially with BAL,is a safe and useful procedure for the evaluation of pulmonary complications,which is particularly suitable for diagnosis of pulmonary infection after BMT.Furthermore,TBLB should be recommended in order to avoid open lung biopsy,if the patients tolerate the operation.