Diagnosis of Infectious Diseases in the Lower Respiratory Tract: A Cytopathologist's Perspective

Abstract

- The lower respiratory tract is subject to infection by a wide variety of infectious agents. Pathologists should be familiar with common organisms, including their general clinical characteristics, cytomorphologic features, differential diagnoses, and ancillary methods of detection. Above all, correlation with microbiologic and clinical information is necessary to make a confident diagnosis of infection.

Role of fine‐needle aspiration cytology in early diagnosis of fungal infections

“…The yield and efficacy of FNA cytology in the identification of pathogens has been demonstrated in several publications 1‐3,9‐14 . Presumptive diagnosis based on morphology of fungal yeasts can be provided in the majority of the cases involving the four most common of these fungi: Histoplasma , Cryptococcus , Blastomyces , and Coccidioides , usually found in immunocompromised patients 11‐12 .…”

“…Presumptive diagnosis based on morphology of fungal yeasts can be provided in the majority of the cases involving the four most common of these fungi: Histoplasma , Cryptococcus , Blastomyces , and Coccidioides , usually found in immunocompromised patients 11‐12 . Characteristic cytologic features, along with appropriate combination of stains (Table 3), allow an accurate distinction among these fungi, especially when the observer is experienced 2,11‐13 . Specific stains such as Romanowsky can facilitate the morphological identification of Histoplasma , Cryptococcus , and Candida , while Papanicolaou stain can aid with Coccidioides and Blastomyces identification.…”

Role of bronchoalveolar lavage in diagnosing pulmonary infections and malignancies: Experience from a tertiary care center

“…While there are a few studies in the literature discussing the diagnostic utility of BAL in different pulmonary pathologies, there is lack of contemporaneous literature on this subject. [2][3][4][5][6] This study was conducted to evaluate the utility of BAL in the diagnosis of various pulmonary disorders.…”

“…It is a frequently used diagnostic modality in pulmonary practice for a variety of indications including infections, especially opportunistic infections, interstitial lung diseases and malignancies. While there are a few studies in the literature discussing the diagnostic utility of BAL in different pulmonary pathologies, there is lack of contemporaneous literature on this subject 2‐6 . This study was conducted to evaluate the utility of BAL in the diagnosis of various pulmonary disorders.…”

Mycobacterium tuberculosis diagnosed promptly by bronchial brushing cytology in an immunocompetent patient

“…The features of TB in bronchial brushing have not been well described previously, and we reported here additional features in bronchial brushings which may be suggestive of TB and should prompt additional investigation for mycobacterium organisms. The cytomorphologic features include scattered acute inflammatory infiltrate and background necrotic debris without viral cytopathic effect or malignant cells 4,5. Although those features are not specific for TB, the use of ancillary tests, such AFB special stain and PCR performed on the sputum or in the cell block can help increase the diagnostic accuracy.…”