Bronchoalveolar lavage fluid cytology in patients with Pneumocystis carinii pneumonia.
OBJECTIVE
To evaluate bronchoalveolar lavage (BAL) cytology and organism burden in patients with Pneumocystis carinii pneumonia (PCP) who were infected with the human immunodeficiency virus (HIV) and in those with other immunodeficiencies.


METHODS
BAL fluid samples from patients with PCP were selected (HIV-infected patients, n = 15; patients with other immunodeficiencies, n = 11). May-Grünwald-Giemsa-stained cytocentrifuge preparations were evaluated. Foamy alveolar casts (FACs) and P carinii clusters were counted.


RESULTS
The numbers of FACs and P carinii clusters in BAL fluid samples of HIV-infected patients were significantly higher as compared to those in samples from patients with other immunodeficiencies. Striking cytologic findings observed in half the samples from both patient groups included the presence of foamy alveolar macrophages, activated lymphocytes, plasma cells and reactive type II pneumocytes. Furthermore, a peculiar cell type, "nonidentified cell" (NIC), was observed almost exclusively in BAL fluid samples from HIV-infected patients.


CONCLUSIONS
BAL fluid samples from HIV-infected patients with PCP displayed higher organism burdens as compared to those from patients with other immunodeficiencies. Moreover, cytologic findings suggestive of noninfectious lung conditions were common in BAL fluid samples obtained from patients with PCP. Further study is required to elucidate the identity of the NIC cell type.
Jacobs
J A
JA
Departments of Medical Microbiology and Pulmonology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. ja@lmib.azm.nl
Dieleman
M M
MM
Cornelissen
E I
EI
Groen
E A
EA
Wagenaar
S S
SS
Drent
M
M
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology* / Q000382:microbiology; D003581:Cytodiagnosis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology; D011010:Pneumocystis / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies