Chest
Clinical InvestigationsDifferential Diagnostic Value of Plasma Cells in Bronchoalveolar Lavage Fluid
Section snippets
Patients
Retrospectively, the initial BAL fluid samples of 1,260 patients with a great variety of pulmonary diseases were selected for study out of all BAL fluid analyses (n = 2,008) performed over a ten-year period between 1980 and 1990.
Bronchoalveolar Lavage
Bronchoalveolar lavage was performed as previously reported during fiberoptic bronchoscopy.3 At the same time, blood samples were drawn for differentia] cell counts. In short, the procedure is as follows. After premedication with atropine and sometimes diazepam and
RESULTS
In 6.6 percent (n = 83) of the cases, PC were detected in the BAL fluid (Fig 1, Table 1). Patients with PC in BAL fluid were most frequently found among those with verified EAA (EAA-group A; 36 of 69 [52.1 percent]). Also, patients with mere clinical symptoms of EAA (EAA-group B; 11 of 26 [42.3 percent]) and those with drug-induced pneumonitis (5 of 14 [35.7 percent]) showed PC in BAL fluid (Table 1). Among the remaining interstitial lung diseases, PC were found in 7 of 100 patients with
DISCUSSION
Plasma cells are seldom found in BAL fluid. Morphologically, these cells can be identified in a routine May-Grünwald-Giemsa-stained slide. The incidence of PC in BAL fluid has been reported in a number of pulmonary disorders, especially in EAA.9 In the present study, PC were found in the BAL fluid obtained from 36 of 69 patients with serologically proven EAA and in 11 of 26 patients with clinical manifestations of the disease. Since nearly no BAL fluid PC were found in other interstitial lung
ACKNOWLEDGMENTS
We gratefully acknowledge Dr. Paul H. G. Mulder for his help with the statistical analysis, Dr. H. C. Hoogsteden for his critical comments, and Mrs. Els Tuenter for her excellent technical assistance.
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This study was supported by a grant from Glaxo BV, the Netherlands.
Manuscript received June 18; revision accepted September 15.