Bronchoalveolar Lavage Analysis with Anti-T6 Monoclonal Antibody in the Evaluation of Diffuse Lung Diseases

Xaubet, Antoni; Agustı́, Carles; Picado, César; Gueréquiz, S.; Martos, J. A.; Carrión, María Teresa; Agustí-Vidal, A

doi:10.1159/000195796

Cited by 20 publications

(11 citation statements)

References 8 publications

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“…Although Auerswald et al 16 and Chollet et al 19 reported good sensitivity of immunocytochemistry against CD1a in BAL fluid as a diagnostic test 16,19,20 , our data are more in accordance with recent evidence indicating a low sensitivity of this approach 21 . Examination of the BAL fluid may be of value in patients with atypical clinical and/or radiological presentation when it can be used to exclude other interstitial lung diseases with more typical lavage findings (e.g., sarcoidosis) and pulmonary infections, such as cavitary forms of Pneumocystis Jiroveci pneumonia or mycobacterial infections.…”

Section: Discussionsupporting

confidence: 90%

Bronchoscopic diagnosis of Langerhans cell histiocytosis and lymphangioleiomyomatosis

Harari

Torre

Cassandro

et al. 2012

Respiratory Medicine

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Limited data are available regarding the role of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBB) as diagnostic tools in pulmonary Langerhans’ Cell Histiocytosis (LCH) and lymphangioleiomyomatosis (LAM). The aim of this study was to review our experience regarding the value of these two techniques in the diagnosis of these cystic lung diseases. Records of 452 patients with the presumptive diagnosis of interstitial lung disease were reviewed; 67 had a clinical-radiological diagnosis of either LCH (n=27) or LAM (n= 40). Of 16 patients with LCH who underwent BAL, four specimens (25%) contained cells which had positive immunoreactivity for CD1a. Of three patients with negative BAL fluid who had TBB, only one had a positive tissue diagnosis. Ten LCH patients were diagnosed by surgical lung biopsy of which five had negative BAL fluid. The remaining 12 patients were diagnosed by clinical and radiologic features. Standard examination of BAL fluid was of no diagnostic value in LAM. TBB was performed in seven patients and was diagnostic in six, not resulting in complications. All 13 patients who underwent surgical lung biopsies had a positive histopathologic diagnosis The remaining 21 patients were diagnosed by clinical and radiologic features. We suggest that BAL may assist in the diagnosis of LCH whereas TBB may be useful in the diagnosis of LAM, thus avoiding the need for surgical biopsy.

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Section: Discussionsupporting

confidence: 90%

Bronchoscopic diagnosis of Langerhans cell histiocytosis and lymphangioleiomyomatosis

Harari

Torre

Cassandro

et al. 2012

Respiratory Medicine

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“…Secondly, increased numbers of Langerhans' cells are recovered from cigarette smokers and patients with other diseases that lead to alveolar epithelial hyperplasia (including fibrotic interstitial lung diseases) and, in our experience, the number of Langerhans' cells observed in such patients overlaps to a large extent with the number recovered from patients with pulmonary LCH 636 37 Thus, in contrast to some reports,38 39 especially those evaluating infants and children,40 we found that, if the threshold for a positive result is fixed at 5% Langerhans' cells, the test is specific but the sensitivity is quite low (<25%).…”

Section: Fibreoptic Bronchoscopy and Bronchoalveolar Lavagecontrasting

confidence: 53%

Rare diseases bullet 9: Adult pulmonary Langerhans' cell histiocytosis

Tazi

Stolzmann²,

Hance³

2000

Thorax

144

101

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“…The identification of LCs among cells recovered by lavage using monoclonal antibodies directed against CD1a (OKT6 or equivalent) has previously been suggested to be useful as a diagnostic test in PLCH [36][37][38], but more recent evidence indicates that this approach can be disappointing and lacks sensitivity. False positive results are common and the specimens must be examined by an experienced cytologist.…”

Section: Pulmonary Langerhans' Cell Histiocytosismentioning

confidence: 99%

Adult pulmonary Langerhans' cell histiocytosis

Tazi¹

2006

European Respiratory Journal

281

297

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Adult pulmonary Langerhans' cell histiocytosis is a rare disorder of unknown aetiology that occurs predominantly in young smokers, with an incidence peak at 20-40 yrs of age. In adults, pulmonary involvement with Langerhans' cell histiocytosis usually occurs as a single-system disease and is characterised by focal Langerhans' cell granulomas infiltrating and destroying distal bronchioles.High-resolution computed tomography (HRCT) of the chest is essential to the diagnosis, typically showing a combination of nodules, cavitated nodules, and thick-and thin-walled cysts. A high macrophage count in bronchoalveolar lavage (BAL) fluid is a common but nonspecific finding that merely reflects exposure to tobacco smoke. BAL is useful for eliminating infections and the other infiltrating lung disorders that can be seen in young adults. Langerhans' cells can be identified in BAL fluid, but, in contrast to what was initially hoped, this test shows a very low sensitivity and is rarely useful in the diagnosis of the disease.The definite diagnosis of pulmonary Langerhans' cell histiocytosis requires identification of Langerhans' cell granulomas, which is usually achieved by surgical lung biopsy at a site selected by chest HRCT. In practice, however, lung biopsy is performed on a case-by-case basis.No effective treatment is available to date, and improved understanding of the mechanisms involved in the pathogenesis of pulmonary Langerhans' cell histiocytosis is urgently needed, and should help in the development of specific therapeutic strategies for patients with this orphan disease.

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Bronchoalveolar Lavage Analysis with Anti-T6 Monoclonal Antibody in the Evaluation of Diffuse Lung Diseases

Cited by 20 publications

References 8 publications

Bronchoscopic diagnosis of Langerhans cell histiocytosis and lymphangioleiomyomatosis

Bronchoscopic diagnosis of Langerhans cell histiocytosis and lymphangioleiomyomatosis

Rare diseases bullet 9: Adult pulmonary Langerhans' cell histiocytosis

Adult pulmonary Langerhans' cell histiocytosis

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