Bronchoalveolar Lavage
(CD3, CD4, CD8, CD16, CD4:8)

FLOW BAL


Test Synonym:



CPT Code:
88184 – Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only, first marker
88185 x4 – Each additional marker (multiple)
88187 – Flow cytometry, interpretation; 2 to 8 markers


Turnaround Time:
<24 hours



Methodology:
Flow cytometry, multiparameter analysis



Specimen Requirements:

10.0mL (min. 5.0mL) Bronchoalveolar lavage in sterile container


Causes for Rejection:

Specimens stored at incorrect temperature; Non-viable specimens; Specimens in inappropriate anticoagulant; Too few cells; Hemolysis; Specimen clotted


Specimen Stability:
 Lavage stable for 48 hours at 2-8°C


Storage and Handling:
• Add 2-4mL MPLN transport medium for overnight shipment.
• Ship with a cool pack (do not allow ice packs to directly contact samples)


Reference Range:
See report

Indication:
Sarcoidosis, lung disease, lung transplantation

References:

  1. Bonara P et al (Aug 1996) Flow cytometric analysis of bronchoalveolar lavage and venous blood lymphocyte phenotype for the diagnosis of acute graft rejection in lung transplant patients. The Lung Transplant Group, Ospedale Maggiore di Milano.  Analytical and Quantitative Cytology and Histology.
  2. Costabel U et al.(1984) T-lymphocytosis in bronchoalveolar lavage fluid of hypersensitivity pneumonitis: changes in profile of T-cell subsets during the course of disease. Chest 85:514-8.
  3. Domagała-Kulawik J et al (Nov 1998) Interstitial lung disease in systemic sclerosis: comparison of BALF lymphocyte phenotype and DLCO impairment.  Respiratory Medicine.
  4. Du Bois RM (Jul 1994)  Fortnightly Review: Diffuse lung disease: an approach to management. British Medical Journal.
  5. Fireman E et al (Mar 1998) Predictive value of response to treatment of T-lymphocyte subpopulations in idiopathic pulmonary fibrosis. The European Respiratory Journal.
  6. Kourakata et al (Sep 1999) Flow cytometric analysis of bronchoalveolar lavage fluid cells in polymyositis/dermatomyositis with interstitial pneumonia.  Respirology.
  7. Moodley YP et al (Aug 2000) Correlation of CD4:CD8 ratio and tumour necrosis factor (TNF)alpha levels in induced sputum with bronchoalveolar lavage fluid in pulmonary sarcoidosis.  Thorax.
  8. Papiris SA et al (Oct 2005) Relationship of BAL and lung tissue CD4+ and CD8+ T lymphocytes, and their ratio in idiopathic pulmonary fibrosis.  Chest.
  9. Papiris SA et al (Jun 2007) CD8+ T lymphocytes in bronchoalveolar lavage in idiopathic pulmonary fibrosis. Journal of Inflammation.
  10. Reichenberger F et al (Jun 2007) Bronchoalveolar lavage quality influences the T4/T8 ratio in sarcoidosis.  Respiratory Medicine.
  11. Smith PA et al (May 2006) Cytometric analysis of BAL T cells labeled with a standardized antibody cocktail correlates with immunohistochemical staining. Cytometry.
  12. Tutor-Ureta P et al (Nov 2006)  Prognostic value of neutrophils and NK cells in bronchoalveolar lavage of sarcoidosis. Cytometry