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
More filters
Journal ArticleDOI
Bronchoalveolar lavage in bronchiolitis obliterans organizing pneumonia primed by radiation therapy to the breast.
Maria Majori,Venerino Poletti,Alessandra Curti,Massimo Corradi,Franco H. Falcone,Alberto Pesci +5 more
TL;DR: The data add to the view that unilateral lung irradiation for breast cancer may "prime the development of a syndrome quite similar to idiopathic bronchiolitis obliterans organizing pneumonia.
Journal ArticleDOI
High-resolution computed tomography patterns of diffuse interstitial lung disease with clinical and pathological correlation
TL;DR: In this article, the most common HRCT patterns seen in cases of diffuse interstitial lung diseases are the nodular pattern, linear/reticular opacities, cystic lesions, ground-glass opACities and consolidations.
Journal ArticleDOI
Interstitial lung disease: the diagnostic role of bronchoscopy.
Jad Kebbe,Tony Abdo +1 more
TL;DR: Recently, the use of cryotherapy via employing a cryoprobe in obtaining transbronchial lung biopsies is unfolding into a refined interventional method which might transform indefinitely the authors' approach to the pathological diagnosis of the various ILDs.
Journal ArticleDOI
Pneumopathies interstitielles diffuses idiopathiques
TL;DR: The classification of pneumopathies interstitielles diffuses (PID) idiopathiques comporte sept entites anatomocliniques, and le diagnostic necessite une approche multidisciplinaire, which integre l’evaluation clinique, le scanner thoracique de haute resolution, and l'aspect histopathologique pulmonaire as mentioned in this paper.
References
More filters
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.
Journal ArticleDOI
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.
Journal ArticleDOI
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.
Journal ArticleDOI
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.