Bronchoalveolar Lavage in a Pediatric Population

Abhishek Gami, Kristina Rinaldi, Yordanos T. Degefe, Arghavan Seyed Vosoughi, Dongwoo Lee, Zahra Maleki

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The cytomorphologic findings of bronchoalveolar lavage (BAL) in pediatrics were correlated with clinical symptoms. Methods: Patient demographics, clinical symptoms/history, cytomorphologic findings, and oil red O (ORO) staining of 100 pediatric patients who underwent BAL between 2014 and 2016 were reviewed at a large academic institution. Results: Of the 100 patients (males/females, 62:38), the most common conditions for BAL included cough (46/100), reflux (39/100), pneumonia (30/100), dysphagia (22/100), asthma (19/100), and cystic fibrosis (15/100). Sixteen of 100 patients were admitted with pulmonary symptoms from the emergency department. Cytomorphologic findings showed acute inflammation in 37 BALs and chronic inflammation in 9. Abundant thick mucin was present in 3 cytology cases from patients with cystic fibrosis. Fungal elements were detected in 3 cases (Candida, Aspergillus, and Pneumocystis jirovecii) and viral effects (rhinovirus) in one. Thirty-seven of 100 had rare ORO-positive lipid-laden macrophages (LLMs), 7 of 100 had moderate LLMs, 11 of 100 had numerous LLMs, 18 of 100 had positive staining without the degree of staining, 25 of 100 had negative ORO staining, and 2 of 100 had noncontributory ORO staining. An iron stain was done on 15 BALs (2 positive, 9 negative, and 4 noncontributory). Conclusions: BAL cytology is a useful tool in pediatrics to discriminate underlying causes of aerodigestive system conditions, while ORO staining may occasionally help.

Original languageEnglish (US)
Pages (from-to)678-684
Number of pages7
JournalAmerican journal of clinical pathology
Volume157
Issue number5
DOIs
StatePublished - May 1 2022

Keywords

  • Bronchoalveolar lavage (BAL)
  • Cytology
  • Iron stain
  • Oil red O stain
  • Pediatrics

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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