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Induced sputum deposition improves diagnostic yields of pulmonary alveolar proteinosis: A clinicopathological and methodological study of 17 cases
- Source :
- Ultrastructural pathology. 40(1)
- Publication Year :
- 2015
-
Abstract
- Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung disease characterized by the accumulation of intra-alveolar lipoprotein-like surfactants. Lung core biopsy and bronchoalveolar lavage (BAL) fluid are currently the two major sources of sampling for diagnosis. In the present study, we assessed the value of induced sputum in diagnosing PAP by transmission electron microscopy and examined the PAP 2-year death rate in Asians. Transmission electron microscopy was performed on the samples from 17 patients with PAP, 13 patients with inflammatory lung diseases, and 13 healthy adults. The PAP patients were followed up for 3-156 months, and inflammatory lung diseases patients or healthy adults for 12-36 months. The ultrastructural features including diagnostic lamellar bodies of induced sputum deposition (ISD) samples were similar to that of the BAL fluid sediment. However, the rates of lamellar bodies were 73.7% in the ISD group, significantly higher than the spontaneous sputum deposition (SSD) group (42.1%, P < .0487) and similar to the BAL sediment (76.2%) and the lung biopsy (54.5%) groups. The overall 2-year death rate of our PAP patients was 17.6% (3/17), not statistically different from the healthy adults and patients with inflammatory diseases (0/13, P = .237 for both). ISD may be the preferred non-invasive sampling method for diagnosing PAP by electronic microscopy because of the higher diagnostic yield than SSD. The diagnostic yields of this noninvasive method were similar to that of lung core biopsy and BAL.
- Subjects :
- Adult
Lung Diseases
Male
Pathology
medicine.medical_specialty
Biopsy
Induced sputum
Lung biopsy
Lamellar granule
Pulmonary Alveolar Proteinosis
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Microscopy, Electron, Transmission
Structural Biology
medicine
Humans
030212 general & internal medicine
Lung
Aged
medicine.diagnostic_test
business.industry
Mortality rate
Sputum
respiratory system
Middle Aged
medicine.disease
respiratory tract diseases
Bronchoalveolar lavage
medicine.anatomical_structure
030228 respiratory system
Female
medicine.symptom
business
Pulmonary alveolar proteinosis
Bronchoalveolar Lavage Fluid
Subjects
Details
- ISSN :
- 15210758
- Volume :
- 40
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Ultrastructural pathology
- Accession number :
- edsair.doi.dedup.....3ff39334bd5e32985e66383e8b61852d