Introduction:Bronchoalveolar lavage (BAL) is a diagnostic procedure by which cells and other components from bronchial and alveolar spaces are obtained for various studies. One of the main advantages of BAL is that it can be done as a day care procedure. Material obtained by BAL can give a definite diagnosis in conditions such as infections and malignancies.Aims:The aims and objective of this study were to assess the utility of BAL as a diagnostic tool to determine the diagnostic accuracy of the material obtained from BAL in various infections and neoplastic lesions to study the limitations of BAL in certain lung disorders.Materials and Methods:This study was done in a tertiary care center in Hyderabad. Bronchoscopy was done as an outpatient procedure and lavage fluid obtained analyzed. This is a prospective study done from January 2012 to Jun 2013. Ninety-one BALs were analyzed for total and differential count, microbiological examination and cytological evaluation. Cases selected included nonresolving pneumonias, diffuse lung infiltrates, infiltrates in immunosuppressed hosts and ventilator-associated pneumonias.Results:Bronchoalveolar lavage was done in 91 cases over a period of 1½ years. Definite diagnosis was not given in 7 cases. Four cases were inadequate. Tuberculosis was diagnosed in 22 cases, fungal infections in 7 cases. Thirty-eight cases of bacterial pneumonias were diagnosed, Klebsiella was the most common organism. Malignancy was diagnosed in 13 cases.Conclusion:Definite diagnosis can be made in tuberculosis, fungal infections, bacterial pneumonias and in malignancies.

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Karyomegalic interstitial nephritis (KIN) is a rare form of, progressive chronic interstitial nephritis. We present a case of KIN in a child, who was also found to have nephrotic syndrome because of focal segmental glomerulosclerosis on renal biopsy. To our knowledge, this is the first case of KIN associated with glomerulopathy.

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We report a case of exogenous lipoid pneumonia from chronic, extranasal use of petrolatum ointment (Vicks VapoRub in this case) for nasal decongestion in a young woman, presenting with cough, dyspnea and fever. Exogenous Lipoid pneumonia is a rare condition, underdiagnosed and is more prevalent in adults. Usually asymptomatic and diagnosed while evaluating predisposed patients who become clinically unstable or an abnormal lung shadow or during evaluation of rhinobronchial allergy. It is rarely reported from chronic use of petrolatum ointment extranasally and was diagnosed by transbronchial biopsy in the present case. She was found, retrospectively, to have been using petrolatum ointment, as an extranasal application since more than a year at bedtime. She didn't give history of using any other oil-based nasal topical vasoconstrictor preparations for sinusitis. Our patient was managed with discontinuation of further use of the petrolatum ointment and treatment with prednisolone apart from her regular treatment for chronic rhinobronchial allergy. Patient is stable without any further radiological deterioration during follow-up of one year.