[How to produce research information from the clinical laboratory--review of our research on the cytological diagnosis of aspergillosis].
We have evaluated the significance of the cytopathological diagnosis of pulmonary aspergillosis using touch smears or lavage fluid obtained by the bronchoscopic examination. Thirty five cases of aspergillosis were diagnosed through the cytological examination of bronchoscopic specimens with abundant neutrophils or necrotic debris from 211 patients. Thirty three of these 35 cases were non-invasive or semi-invasive and the remaining two cases were allergic aspergillosis. Aspergilli could be cultivated from the bronchoscopic specimen only in 34% of these 35 cases. Serum beta-D glucan and galactomannan were elevated in 27% and 12% respectively. Although 92% of these 35 cases had high titer of aspergillus antibody, less than 40% of them had been suspected to be aspergillosis at the time of bronchoscopic examinations. These data clearly indicates that cytopathological examination is quite effective to make the diagnosis of pulmonary aspergillosis especially in the clinically unsuspected cases. Our experimental study revealed that Papanicolou's staining is able to color the cytoplasm of the fungal hyphae but ineffective to demonstrate empty wall of the degenerated hyphae. In our 35 aspergillosis, hyphae are frequently invisible in the slides stained with Papanicolou's method (21/35), because of the degenerative change. However, degenerated hyphae of these 21 cases were clearly demonstrated by special stain for fungi. In conclusion, application of the fungal stain to the bronchial cytological slides rich in neutrophils and/or necrotic debris is revealed to have clinical significance for the accurate diagnosis of pulmonary aspergillosis.
Hara
Kiyokazu
K
Department of Pathology, National Hospital Organization Shiga Hospital, Higashiohmi.
Okabe
Hidetoshi
H
D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis; D001230:Aspergillus / Q000302:isolation & purification / Q000378:metabolism / Q000472:pathogenicity; D001999:Bronchoscopy; D003581:Cytodiagnosis / Q000379:methods*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods