Bronchoalveolar lavage cell analysis in a child with chronic lipid pneumonia.
In an asymptomatic 4 yr old child with radiographic evidence of parenchymal lung disease, bronchoalveolar lavage (BAL) yielded the diagnosis of chronic lipid pneumonia caused by chronic aspiration of mineral oil given as a laxative. BAL analysis showed a marked reduction in the total number of alveolar macrophages; almost 70% of these cells contained intracytoplasmic lipid vacuoles. It also disclosed lymphocytic (cytotoxic/suppressor) alveolitis. A high percentage of lymphocytes expressed antigen markers of activation (human leucocyte antigen (HLA)-DR), CD54 and CD25). BAL analysis 18 months after mineral oil intake revealed that lymphocytes bearing antigen markers of activation had markedly decreased whereas alveolar macrophages (normal and lipid-laden) had increased. A subsequent whole lung BAL was considered unnecessarily invasive in this otherwise healthy child.
Midulla
F
F
IV Dept of Pediatrics, Institute of Pediatrics, University of Rome La Sapienza, Italy.
Strappini
P M
PM
Ascoli
V
V
Villa
M P
MP
Indinnimeo
L
L
Falasca
C
C
Martella
S
S
Ronchetti
R
R
D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D016131:Lymphocyte Subsets / Q000473:pathology; D008297:Male; D008899:Mineral Oil / Q000009:adverse effects / Q000627:therapeutic use; D011017:Pneumonia, Lipid / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D002400:Cathartics; D008899:Mineral Oil