Lung Lavage Cell Profiles in Diffuse Lung Disease

The standard armamentarium of tests that are used by pulmonologist are laboratory tests, pulmonary function tests, different radiological techniques (conventional chest-X rays, HRCT scans, etc) and pathohistological analyses of biopsies. The minimally invasive bronchoalveolar lavage (BAL) procedure, in addition to methods earlier mentioned, is an important diagnostic instrument that can facilitate the diagnosis of various diffuse lung diseases (DLD). BAL fluid white blood cell profiles are analyzed, malignant cells looked for, and in certain circumstances particular stains are performed to detect yet other cell types. Additionally, BAL can play a very important role in the diagnosis of respiratory tract infections. All these analyses are usually readily performed in a moderately equipped cytological laboratory

Detection of human papillomaviruses type 16, 18 and 33 in bronchial aspirates of lung carcinoma patients by polymerase chain reaction: a study of 84 cases in Croatia [Određivanje humanog papiloma virusa tipa 16, 18 i 33 u aspiratima bronha pacijenata s karcinomom pluća metodom lančane reakcije polimerazom: istraživanje 84 pacijenta u Hrvatskoj]

Besides its well-known role in cervical carcinoma, HPV is also suggested to be involved in lung cancer development. A number of authors have been investigating the presence of HPV in histological materials. We used routine bronchial aspirates from 84 patients with lung carcinoma for DNA extraction and then performed polymerase chain reaction for high-risk HPV types 16, 18 and 33. The results were compared to those obtained from buccal and eyelid mucosa. Only three patients were positive for HPV in bronchial aspirates: one for HPV 16 type, one for HPV 18 type, and one for HPV 33. Our data indicated the low prevalence of HPV in patients with lung carcinomas in Croatia, therefore it seems unlikely that HPV contributes to the development of lung carcinomas in this region

Necrotising Sarcoid Granulomatosis of the Spinal Cord: Case Report

We report a patient who presented with leg weakness and cervical lymphadenopathy. Thoracical magnetic resonance imaging showed an inhomogenously increased signal in the thickened portion of the cord. Multilevel laminectomy and spinal cord biopsy revealed granulomatous infiltrations with necrosis. Review of the histopathological finding established the diagnosis of necrotising sarcoid granulomatosis (NSG) of the spinal medulla, cytological FNA diagnosis of the neck lymph node was granulomatous inflammation with necrosis, but histopathological analysis of the same neck lymph node disclosed granulomatous inflammation without necrosis. On further radiographic chest evaluation mediastinal lymphadenopathy was found. Immunophenotyping of lymphocytes in bronchoalveolar lavage fluid (BALF) was indicative of sarcoidosis. After the administration of corticosteroid therapy the patient’s clinical condition improved, and laryngeal and mediastinal lymph nodes subsided with minor changes remaining in the spinal medulla, which, based upon MR assessment, were considered to be irreversible. To our knowledge, this is the first described case with finding of granulomatous inflammation with and without vasculitis in various organs, consistent with the Churg’s study who believes NSG to be a histological variant of sarcoidosis

Number of Counting Cells and Cytospins Selection Influences on Bronchoalveolar Lavage Cell Profiles

Bronchoalveolar lavage (BAL) fluid cells count provides information about presence or absence of interstitial lung diseases. BAL fluid samples were taken from 50 patients hospitalized in University Hospital for Lung Diseases »Jordanovac« in Zagreb, Croatia. The samples of BAL fluid were prepared by cytocentrifuge. From each sample two cytospin were selected (C1 and C2) and after determing adequacy, counted up to 200 and 400 cells. After air drying, samples were stained according to May Grünwald Giemsa (MGG). Cells were counted by light microscope at magnification of 400x. Obtained results were analyzed in Statistics version 6 and Med Calc. Results for bronchial epithelial cells, alveolar macrophages, lymphocytes and neutrophilic granulocytes showed insignificant statistical differences between groups (p>0.05). Eosinophils percentages showed borderline insignificant statistical difference between groups of these cells (p=0.052.). As it was exemplificated, the percentages of differentiated cells do not significant differ according to differentiation on 200 and 400 cells and cytospin selection

Number of Counting Cells and Cytospins Selection Influences on Bronchoalveolar Lavage Cell Profiles

Bronchoalveolar lavage (BAL) fluid cells count provides information about presence or absence of interstitial lung diseases. BAL fluid samples were taken from 50 patients hospitalized in University Hospital for Lung Diseases »Jordanovac« in Zagreb, Croatia. The samples of BAL fluid were prepared by cytocentrifuge. From each sample two cytospin were selected (C1 and C2) and after determing adequacy, counted up to 200 and 400 cells. After air drying, samples were stained according to May Grünwald Giemsa (MGG). Cells were counted by light microscope at magnification of 400x. Obtained results were analyzed in Statistics version 6 and Med Calc. Results for bronchial epithelial cells, alveolar macrophages, lymphocytes and neutrophilic granulocytes showed insignificant statistical differences between groups (p>0.05). Eosinophils percentages showed borderline insignificant statistical difference between groups of these cells (p=0.052.). As it was exemplificated, the percentages of differentiated cells do not significant differ according to differentiation on 200 and 400 cells and cytospin selection

Detection of Human Papillomaviruses Type 16, 18 and 33 in Bronchial Aspirates of Lung Carcinoma Patients by Polymerase Chain Reaction: A Study of 84 Cases in Croatia

Besides its well-known role in cervical carcinoma, HPV is also suggested to be involved in lung cancer development. A number of authors have been investigating the presence of HPV in histological materials. We used routine bronchial aspirates from 84 patients with lung carcinoma for DNA extraction and then performed polymerase chain reaction for high-risk HPV types 16, 18 and 33. The results were compared to those obtained from buccal and eyelid mucosa. Only three patients were positive for HPV in bronchial aspirates: one for HPV 16 type, one for HPV 18 type, and one for HPV 33. Our data indicated the low prevalence of HPV in patients with lung carcinomas in Croatia, therefore it seems unlikely that HPV contributes to the development of lung carcinomas in this region

Clinical Cytology and Primary Health Care of Children and Adults

Clinical cytology is a diagnostic branch of medicine, best known by the Papa test in gynaecology. But, cytology can be applied in almost all fields of clinical medicine. Its advantages – high accuracy, simplicity, with little or no aggressiveness and low cost – are not used as widely as they could be. Medical practice, as well as medical research, and also medical education, are nowadays often directed at profitable use and not at the real benefit of the patient. Primary practitioners do not have enough chance to get acquainted with clinical cytology as a whole although they need true information, based on the cost-effectiveness and patient-benefit. A panel discussion on this subject was organised at the 4th Croatian Congress of Clinical Cytology, in Split, October 11–14, 2009 by the Croatian Society for Clinical Cytology-Croatian Medical Asoctiation, to inform primary practitioners about the possibilities of cytodiagnostics in the health care of children and adults. Indications for cytodiagnostics in infectious diseases (T. Jeren and A. Vince), haematology (I. Kardum-Skelin), pulmonology (S. Smojver-Je`ek), thyroid diseases (A. Kne`evi}-Obad), breast diseases (I. Kardum-Skelin), gastroenterology and urology (G. Kai}) were discussed, as well as technical procedures and the interpretation of the cytological findings. Moderator (@. Znidar~i}) opened the panel with presentation about the role of clinical cytology, particularly in the primary health care. The discussion finally pointed at the necessity of better communication between primary practitioners and cytologists. This review article presents contents of the panel discussion

Morphometric and DNA Image Analysis of Bronchoalveolar Lavage Fluid Macrophages Nuclei in Interstitial Lung Diseases with Lymphocytic Alveolitis

Lymphocytic alveolitis is a characteristic of diverse interstitial lung diseases (ILD-s), but macrophages are often more numerous cell population in bronchoalveolar lavage fluid (BALF). Aim of this study is to analyze morphometric characteristics of macrophages nuclei in BALF in patients with ILD-s and to detect possible differences allowing distinguishing sarcoidosis from other lymphocytic alveolitis ILD-s. Thirty-one patient with interstitial lung disease who had lymphocytic alveolitis in BALF cell count (17 sarcoidosis and 14 other ILD-s) and nine controls were included in the study. The following patients data were numbered: age, lymphocyte percentage and CD4/CD8 ratio in BALF. Investigated morphometric parameters of macrophages nuclei were: area, outline, maximal radius, minimal radius, length, breadth, form factor (FF), elongation factor (EF) and DNA image cytometry ploidy status determined with Van Velthoven method. Predicted classifications in classification matrix (forward step-wise method in multivariate discriminant function analysis) based on macrophages nuclei length mean, minimum and maximum, breadth SD, FF mean and lymphocyte % were 100% (9/9) correct for control group, 88.235% (15/17) correct for sarcoidosis, and 92.857% (13/14) correct for other lymphocytic alveolitis ILD group. In total, 92.5% (37/40) of the examinees were correctly classified in particular group upon the observed variables

Synchronous Bilateral Breast Carcinoma with Two Different Morphology Subtypes: A Case Report

We report a case of synchronous bilateral breast cancer with ductal and medullary carcinoma. A 60-year-old woman presented with lesion in both breasts which were mammographicaly found two years ago. Ultrasonography proved two suspected masses in breasts. Fine needle cytology was performed and confirmed bilateral carcinoma but with different cytological findings. The cytological feature of the left breast suggested ductal carcinoma and of the right breast raised possibility of a medullary carcinoma. Patient underwent bilateral quadrectomy with evacuation of axillary lymph nodes. Histological examination showed bilateral carcinoma with two different histological features: ductal in the left and medullary carcinoma in the right breast