Bronchoalveolar Lavage in a Pediatric Population: A Correlation of Clinical Symptoms and Cytomorphologic Findings. Issue 5 (26th October 2021)

• Record Type: Journal Article
• Authors: Gami, Abhishek; Rinaldi, Kristina; Degefe, Yordanos T; Vosoughi, Arghavan Seyed; Lee, Dongwoo; Maleki, Zahra
• Is Part Of: American journal of clinical pathology. Volume 157:Issue 5(2022)
• Page Start: 678
• Page End: 684
• Publication Date: 2021-10-26
• Subjects: Bronchoalveolar lavage (BAL) -- Pediatrics -- Cytology -- Oil red O stain -- Iron stain; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqab177
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: The cytomorphologic findings of bronchoalveolar lavage (BAL) in pediatrics were correlated with clinical symptoms. Methods: Patient demographics, clinical symptoms/history, cytomorphologic findings, and oil red O (ORO) staining of 100 pediatric patients who underwent BAL between 2014 and 2016 were reviewed at a large academic institution. Results: Of the 100 patients (males/females, 62:38), the most common conditions for BAL included cough (46/100), reflux (39/100), pneumonia (30/100), dysphagia (22/100), asthma (19/100), and cystic fibrosis (15/100). Sixteen of 100 patients were admitted with pulmonary symptoms from the emergency department. Cytomorphologic findings showed acute inflammation in 37 BALs and chronic inflammation in 9. Abundant thick mucin was present in 3 cytology cases from patients with cystic fibrosis. Fungal elements were detected in 3 cases ( Candida, Aspergillus, and Pneumocystis jirovecii ) and viral effects (rhinovirus) in one. Thirty-seven of 100 had rare ORO-positive lipid-laden macrophages (LLMs), 7 of 100 had moderate LLMs, 11 of 100 had numerous LLMs, 18 of 100 had positive staining without the degree of staining, 25 of 100 had negative ORO staining, and 2 of 100 had noncontributory ORO staining. An iron stain was done on 15 BALs (2 positive, 9 negative, and 4 noncontributory). Conclusions: BAL cytology is a useful tool in pediatrics to discriminate underlying causes of aerodigestive system conditions, while ORO staining may occasionally help.