[Difficulties in the interpretation BALF and induced sputum cell smears].
The role of quantitative methods in the cytological diagnosis of pulmonary diseases increases in recent years. Bronchoalveolar lavage (BAL) and induced sputum (IS) belong to these methods. Bronchoalveolar lavage plays an important role in the diagnosis of interstitial lung diseases, IS - in the differential diagnosis of asthma, chronic obstructive lung disease, persistent cough. Both methods are valuable in the evaluation of pathogenesis of lung diseases. The aim of this presentation is to show the main similarities and differences in the morphology of cells in the BAL and IS and difficulties in the interpretation of results of these examinations (on the basis of 1000 BAL and 200 IS smears). The preparation of cell smears according to the obligatory standards plays the most important role in the quality of BAL and IS. If the fluid is bloody or epithelial cells are numerous it can not be qualified as diagnostic. A very good knowledge of the cell morphology is necessary in the quantitative analysis. Epithelial cells, macrophages, lymphocytes, neutrophils and eosinophils are routinely identified. Alveolar macrophages are very numerous heterogeneous cell population in the BAL. IS macrophages are less numerous, are smaller in size, have more condensed cytoplasm, contain less cigarette smoke particles, have higher expression of activation markers than BAL cells. Neutrophils are larger and eosinophils more often degranulated in the IS than in the BALF. Interpretation of squamous epithelial cells needs caution because of the phagocytary function of these cells. This study details differences significant in quantitative and qualitative analysis of BAL and IS in routine and immunocytochemical tests.
Domagała-Kulawik
Joanna
J
Katedra i Klinika Chorob Wewnwtrznych, Pneumonologii i Alergologii, Akademia Medyczna w Warszawie, Warszawa, Poland. jokula@amwaw.edu.pl
D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D006801:Humans; D007150:Immunohistochemistry; D008171:Lung Diseases / Q000175:diagnosis* / Q000473:pathology; D013183:Sputum / Q000166:cytology*