Interstitial lung diseases (ILDs), also known as diffuse parenchymal lung disorders, can be difficult to diagnose since treatment and prognosis are heavily dependent on an accurate diagnosis. A multidisciplinary approach has become the standard of treatment, and it has been demonstrated to be the key to establishing an accurate diagnosis with the least intrusive method. This team, which often consists of pulmonologists, rheumatologists, radiologists, and pathologists, is critical in arriving at the right and final diagnosis. In the past, the histologic diagnosis was thought to be the be-all and end-all of ILD definitive diagnosis. However, this is no longer the case. Certain ILDs, such as idiopathic pulmonary fibrosis, can now be diagnosed based on clinical presentation, serologies, and high-resolution computed tomography of the chest if the symptoms are characteristic, without the requirement for bronchoalveolar lavage or histology. Not all suspected ILDs require biopsies! Because of variations in origin, clinicopathologic characteristics, treatment choices, and prognosis, a correct diagnosis is critical. 

This article summarises the current state of the literature on the use of bronchoscopy in the diagnosis of ILDs.

Reference:https://journals.lww.com/clinpulm/Abstract/2020/05000/Bronchoscopic_Myths_and_Legends__Utility_of.4.aspx