Clinical implications of bronchoalveolar lavage fluid cellular analysis in fibrotic interstitial lung disease combined with CT quantification

This study evaluated the clinical significance of combining bronchoalveolar lavage fluid (BALF) cellular analysis with CT quantification in patients with fibrotic interstitial lung disease (ILD). A higher proportion of neutrophils in BALF was associated with a greater decline in forced vital capacity (FVC), while lymphocyte proportion showed a negative correlation with the extent of honeycombing. Patients with neutrophilic inflammation demonstrated more severe functional impairment, whereas a lymphocytic pattern was associated with less advanced fibrosis. Quantitative CT analysis was performed using AVIEW software (Coreline Soft), enabling objective assessment of fibrotic patterns including normal lung, emphysema, consolidation, ground-glass opacity (GGO), reticulation, and honeycombing. These findings suggest that integrating BALF cellular profiles with CT-based quantification provides complementary insights for refined phenotyping and improved prognosis prediction in fibrotic ILD.