Bronchoalveolar lavage in the diagnosis of lipoid pneumonia

Jan F. Silverman, Robert C. Turner, R. Lee West, Thomas A. Dillard

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Lipoidpneumonia (LP) is an uncommon entity with the characteristic radiographic features and histologic findings of alveoli filled with vacuolated, lipid‐laden histiocytes. We questioned whether bronchoalveolar lavage (BAL) could be useful in the confirmation of LP. We examined lipid stains (oil‐red O) in BAL specimens from 18 cases, representing a variety of pulmonary disease states, and compared them with an index case of confirmed LP. The index case of LP had a history of chronic intranasal use of mentholated petrolatum with subsequent x‐ray findings of progressive air bronchograms. Positive histochemical confirmation (oil‐red O) performed on frozen sections of transbronchial lung biopsy was obtained. Eleven of the non‐LP cases had no intracellular staining of BAL macrophages with oil‐red O stain, whereas the index case of LP exhibited markedly positive intracytoplasmic staining of macrophages for lipid. The remaining seven cases showed minimal to mild lipid staining with only one other case having moderate staining. This study demonstrates that BAL macrophages from patients with a variety of pulmonary states and without suspected LP do not demonstrate significant staining for intracellular lipids, in contrast with the expected strong positivity of LP. Lipid staining of BAL specimens, although not entirely specific may be a preferred method for confirming the diagnosis of LP. thereby avoiding more invasive procedures.

Original languageEnglish (US)
Pages (from-to)3-8
Number of pages6
JournalDiagnostic Cytopathology
Volume5
Issue number1
DOIs
StatePublished - Jan 1989

Keywords

  • Bronchoalveolar lavage
  • Cytology
  • Lipoid pneumonia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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    Silverman, J. F., Turner, R. C., West, R. L., & Dillard, T. A. (1989). Bronchoalveolar lavage in the diagnosis of lipoid pneumonia. Diagnostic Cytopathology, 5(1), 3-8. https://doi.org/10.1002/dc.2840050103