Author/Editor		Kern, Izidor; Eržen, Damijan; Kecelj, Peter; Košnik, Mitja; Mermolja, Milivoj
Title		Citologija bronhoalveolarnega izpirka pri intersticijskih pljučnih bolezni
Translated title		Cytology of bronchoalveolar lavage fluid in the interstitial lung diseases
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 4
Publication year		2003
Volume		str. 217-21
Language		slo
Abstract		Background. By the bronchoscopic lavaging we obtain cytological specimen of the peripheral airways and lung parenchyma. Bronchoalveolar lavage f luid (BALF) examinationgives us information about inflammation in the interstitial lung diseases. BALF sampling and its laboratory processing are standardized in our hospital. Quality assurance practice requires that each institution establish disease characteristic BALF profiles. The aim of this study was to find common cytological characteristics of BALF specimens in sarcoidosis, extrinsic allergic bronchoalveolitis (EABA), asbestosis and idiopathic interstitial pneumonias (IIP). Material and methods. We included 135 BALF specimens of good quality from patients with one of the mentioned entities that were diagnosed clinically, radiographically and pathologically. Based on diferential cell counts and lymphocytic phenotypisation done by immunofluorescence, BALF specimens were categorized as normal type, lymphocytic, neutrophilic, eosinophilic, macrophagic and mixed cell alveolitis. Statistical comparison was performed by the analysis of variance which was done by SAS software. Results. BALF in sarcoidosis shown in 71% lymphocytic or mixed cell (lymphocytic and neutrophilic or eosinophilic) type alveolitis with increased CD4/CD8 ratio (>3.5) in 61.4% specimens. EABA patients had lymphocytic or mixed cell (lymplaocytic and neutrophilic or eosinophilic) type alveolitis in 53.3% of BAlFspecimens with decreased CD4/CD8 ratio (< 1) in 38.5% of specimens. Macrophagic alveolitis was the most common type found in asbestosis (52.9%). CD4/CD8 ratio was usually decreased or normal. Patients with IIP had all types of alveolitis and none of them prevailed, but neutrophils were increased often (53.3%). CD4/CD8 ratio was decreased in 65.5% of BALF specimens in IIP. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Bronhoalveolarni izpirek (BAI) je celični vzorec, ki ga dobimo z izpiranjem perifernih dihalnih poti in pljučnega parenhima med bronhoskopijo. S pregledom vzorca BAI dobimo pomembne informacije o vnetnem dogajanju pri intersticijskih pljučnih boleznih. Postopek odvzema vzorca BAl in njegova laboratorijska obdelava sta v naši bolnišnici standardizirana. Za zagotavljanje kakovosti je priporočljivo, da ima vsaka ustanova svoje značilne vrednosti za posamezne bolezni. Namen analize je bil prikazati citološke značilnosti BAI pri bolnikih s sarkoidozo, z ekstrinzičnim alergijskim bronhoalveolitisom (EABA), azbestozo in idiopatskimi intersticijskimi pljučnicami (IIP). Material in metode. V analizo smo zajeli 135 vzorcev BA1 ustrezne kakovosti bolnikov, ki so imeli klinično, rentgenološko in patološko diagnosticirano eno od omenjenih diagnoz. Po opravljeni diferenciaciji neepitelnih celic v citospinih in fenotipizaciji limfocitov z imunofluorescenco smo jih razvrstili v naslednje kategorije: normalni BAI, limfocitni, nevtrofilni, eozinofilni, makrofagni in mešanocelični alveolitis. Statistično metodo analize variance smo opravili s pomočjo programske opreme SAS. Rezultati. BAI bolnikov s sarkoidozo je bil v 72% limfocitni ali mešanocelični (limfocitni in nevtrofilni ali eozinofilni). Zvišano razmerje (>3,5) CD4/CD8 limfocitov T je bilo pri 62,4% BAI bolnikov s sarkoidozo. BAI bolnikov z EABA je bil v 53,3% limfocitni ali mešanocelični (limfocitni in nevtrofilni ali eozinofilni). Znižano razmerje (< 1) CD4/CD8 limfocitov T je bilo pri 38,5% bolnikov z EABA. Pri bolnikih z azbestozo je bil najbolj pogost makrofagni alveolitis (52,9%) z normalnim ali znižanim razmerjem CD4/CD8. Bolniki z IIP so imeli različne alveolitise v BAI, najpogosteje (53,3%) je bil prisoten povišan delež nevtrofilcev. V 65,5% je bilo razmerje CD4/CD8 znižano. (Izvleček prekinjen pri 2000 znakih).
Descriptors		LUNG DISEASES, INTERSTITIAL BRONCHOALVEOLAR LAVAGE FLUID BRONCHOALVEOLAR LAVAGE SARCOIDOSIS, PULMONARY ALVEOLITIS, EXTRINSIC ALLERGIC ASBESTOSIS LYMPHOCYTE SUBSETS NEUTROPHILS MACROPHAGES