Bronchoscopy and Bronchoalveolar Lavage (BAL)
Reviewed
Also called: Bronchoscopy, Bronchoalveolar Lavage, Flexible bronchoscopy, Bronchoalveolar washing
A bronchoscopy is a procedure that's used to check for the cause of a lung problem. It can also be used to treat some lung diseases.
Specimen: Bronchoalveolar lavage (BAL) fluid
Why this test may be ordered
- To find the cause of lung symptoms like a persistent cough, trouble breathing, or coughing up blood
- To diagnose lung infections such as tuberculosis, bacterial pneumonia, or fungal infections
- To diagnose lung cancer or determine its severity
- To remove blockages, tumors, or control bleeding in the airways
Preparation and collection
You may need to fast (not eat or drink) for several hours before your procedure. Your provider will let you know how long you need to avoid food and drink. You may need to stop taking certain medicines before this test, so tell your provider about everything you take. But don't stop taking any medicines unless your provider tells you to. If you've been given a sedative, you may be drowsy for a few hours after your procedure and should arrange to have someone take you home.
A bronchoscopy takes about 30 to 90 minutes and usually includes the following steps. You may get medicine (sedative) to help you relax. Your provider will spray a numbing medicine in your mouth and throat so you won't feel any pain during the procedure. Your provider will insert the bronchoscope down your throat and into your airways. Your provider will put a small amount of saline through the bronchoscope. After washing the airways, the saline is sucked up into the bronchoscope.
There is very little risk to having a bronchoscopy or a BAL. Serious complications are rare, but they may include bleeding in the airways, infection, or a pneumothorax ( collapse of part of your lung). Your mouth and throat may be numb for a few hours. You will have to wait to eat or drink until the numbness is gone. You may have a sore throat, cough, or hoarseness for a day or more.
Understanding results
Your provider may consider your symptoms, medical history, and the results of other tests to understand the results of your procedure.
- Bronchoscopy: abnormal findings: If your bronchoscopy results were not normal, it may be a sign of lung disorder such as: A blockage, growth, or tumor in the airways, Narrowing of part of the airways, Lung damage due to an immune disorder such as rheumatoid arthritis. Limitation: Your provider may consider your symptoms, medical history, and the results of other tests to understand the results of your procedure. Next step: If you have questions about your results, talk to your provider.
- BAL lung sample: abnormal results: it may be a sign of lung cancer or a type of infection such as: Tuberculosis, Bacterial pneumonia, Fungal infection. Limitation: Your provider may consider your symptoms, medical history, and the results of other tests to understand the results of your procedure. Next step: If you have questions about your results, talk to your provider.
- Results from bronchoscopy and BAL are not diagnostic on their own; they must be interpreted along with your symptoms, medical history, and other tests.
- There is a small risk of false negatives; a normal result does not completely rule out disease.
- The procedure carries rare but serious risks such as bleeding, infection, or lung collapse.
What to do next
If you have questions about your results, talk to your provider. If you had a tissue sample taken, you may also have a chest x-ray done to check for any issues.
- What do my results mean for my health?
- Do I need any follow-up tests or procedures?
- What are the next steps in my treatment?
- Are there any symptoms I should watch for after the procedure?
- How will my results affect my treatment plan?
Evidence source
Source: U.S. National Library of Medicine (MedlinePlus). Practices and reference ranges may differ in your country.
U.S. National Library of Medicine: Bronchoscopy and Bronchoalveolar Lavage (BAL)