Pulmonary cytology in patients with the acquired immunodeficiency syndrome (AIDS)

Over a 2-yr period, 1982-1984, 181 pulmonary cytology specimens were obtained from 45 patients clinically suspected of having AIDS in an attempt to identify the various organisms and the cytologic atypias present in pulmonary cells. Cytologic correlations with autopsy findings were available for 28 of these cases (62%). Specimens were collected from sputum, bronchial washes and brushes, bronchoalveolar lavages, and pleural fluid. Of the 181 specimens, 121 (67%) were of diagnostic value. Depending on the cytologic technique, Pneumocystis carinii, cytomegalovirus, herpesvirus, and Candida were detected with varying frequency. The bronchial epithelial and glandular cell atypias, ranging from mild inflammatory reactive changes to marked cellular atypia, were noted most often in specimens from patients with pulmonary infections who were concurrently receiving oxygen therapy and/or chemotherapy for Kaposi's sarcoma or central nervous system lymphoma. An awareness of the wide range of AIDS-associated pulmonary cell atypias is required to rule out a diagnosis of malignancy.