The diagnostic value of bronchoalveolar lavage and transbronchial lung biopsy in cryptogenic organizing pneumonia
TLDR
In this article, the diagnostic value of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) in cryptogenic organizing pneumonia (COP) was determined.Abstract:
In order to determine the diagnostic value of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) in cryptogenic organizing pneumonia (COP) a prospective study was carried out. Thirty seven consecutive patients (20 males and 17 females) with clinicoradiological features of COP were enrolled in the study. The statistical analyses were completed in 35 cases. Twenty eight patients were diagnosed to have COP, all of them with a confirmatory biopsy. In seven cases, a different diagnosis was made. BAL cytological and phenotypical criteria considered for the diagnosis of COP were: a lymphocytosis of more than 25% (with a CD4/CD8 ratio less than 0.9); combined with at least two of the following data (foamy macrophages of > 20%, and/or neutrophils of > 5%, and/or eosinophils of > 2% and < 25%). TBLB specimens were classified as positive for COP if they showed: buds of granulation tissue within the centrilobular air spaces; infiltration of alveolar walls with chronic inflammatory cells; and preservation of alveolar architecture. BAL was performed in 34 patients; 17 cases were consistent with the final diagnosis of COP (sensitivity 63%), and four cases were correctly classified as negative (specificity 57%). BAL had a positive predictive value (PPV) of 85% and a negative predictive value (NPV) of 29%. TBLB was performed in 32 patients; it correctly identified COP in 16 cases (sensitivity 64%), and six cases were correctly classified as negative (specificity 86%). TBLB had a PPV of 94% and a NPV of 40%. The accuracy of the examinations, that is the probability of correctly diagnosing both diseased and nondiseased patients by BAL or TBLB, was 62 and 69%, respectively. Our findings suggest that the combination of cytological bronchoalveolar lavage and histological transbronchial lung biopsy data obtained during a fibreoptic procedure appears to be an effective method for the initial investigation in cryptogenic organizing patients pneumonia presenting with patchy radiographic shadows.read more
Citations
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Journal ArticleDOI
Transbronchial Pulmonary Biopsies
G. Casoni,C Gurioli,V. Poletti +2 more
TL;DR: The bronchoscopic pulmonary biopsy, defined also as transbronchial lung biopsy (TBLB), is a procedure with low morbidity and mortality and the main complication is bleeding; less frequent complications are pneumothorax, hypoxemia, or cardiac arrhythmias during the procedure.
Journal ArticleDOI
[Bronchiolitis obliterans organizing pneumonia--experience of a pulmonology ward].
TL;DR: The authors emphasise the time symptoms took to develop, the failure of multiple antibiotics, agreement between symptoms and imaging with those published in the literature, the increased lymphocytes in the BAL, the usefulness of TBLB and the good response to corticosteroids.
Journal ArticleDOI
A case of bronchiolitis obliterans organising pneumonia associated with SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis) syndrome
Fawad Hameed,Henry Steer +1 more
TL;DR: A 57-year-old woman with SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis) syndrome presented with recurrent episodes of pneumonia, the first reported case of organising pneumonia (OP) in association with SaphO syndrome is reported.
Journal ArticleDOI
Bronchoalveolar lavage. Technical notes.
TL;DR: Bronchoalveolar lavage should be performed with at least 100 ml and cytologycal analysis and cytofluorimetric procedures are considered as the more appropriate workup.
Journal ArticleDOI
Neumonía criptogénica organizada como diagnóstico diferencial de neumonía que no responde a tratamiento
Felipe Olivares A,Alberto Fica C,Paulo Charpentier,Antonio Hernández M,María Eugenia Manríquez A,Marcelo Castro S +5 more
TL;DR: In patients with non-resolving pneumonia, a dedicated and comprehensive study should be done using invasive procedures and considering both infectious and non-infectious causes, one of the alternatives that is potentially treatable, but often under diagnosed.
References
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Journal ArticleDOI
Cryptogenic organizing pneumonitis.
TL;DR: Eight patients with histological intra-alveolar organization, but no evidence of an infective or other aetiological agent, are reported, and the term cryptogenic organizing pneumonitis is suggested to avoid confusion with post-infective organizing pneumonia.
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Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients.
TL;DR: Three characteristic clinical and imaging profiles in patients with idiopathic BOOP are distinguished: multiple patchy pneumonia, solitary pneumonia, and diffuse interstitial lung disease.
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Cryptogenic organizing pneumonia: CT findings in 43 patients.
TL;DR: It is concluded that in immunocompetent patients the CT findings in cryptogenic organizing pneumonia most commonly consist of bilateral areas of consolidation involving mainly the subpleural and/or peribronchovascular regions.
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Rapidly progressive bronchiolitis obliterans with organizing pneumonia.
TL;DR: There is a subset of patients with BOOP who present with a fulminant course leading to death or chronic severe fibrosis and marked impairment of lung function and the histologic picture of BOOP may be a manifestation of early lung injury that can resolve or progress rapidly to alveolar septal inflammation, end-stage fibrosis, and honeycombing.