Bronchoalveolar Lavage Cytology an Added Value in Sputum-negative Cases

A BSTRACT Sputum-negative pulmonary tuberculosis (TB) presents a diagnostic challenge, especially in cases where clinical suspicion is high but conventional sputum studies are inconclusive. Bronchoalveolar lavage (BAL) cytology, combined with microbiological and molecular assays, significantly enhances diagnostic yield. We present a case of an 18-year-old male with a cough and expectoration whose sputum was tested negative for TB. On performing broncho alveolar lavage cytology while awaiting cartridge-based nucleic acid amplification test and culture reports, there was evidence of scattered epithelioid cells and giant cells. Ziehl–Neelsen stain was positive for acid fast bacilli. Broncho alveolar lavage cytology can be used as an added value in such cases to reduce the infectivity.