Bronchoalveolar Lavage in a Pediatric Population

Area of Science:

• Pediatric Pulmonology
• Cytopathology
• Diagnostic Imaging

Background:

• Bronchoalveolar lavage (BAL) is frequently performed in pediatric patients to investigate respiratory symptoms.
• Understanding the cytomorphologic findings in BAL is crucial for diagnosing various conditions affecting the aerodigestive system in children.

Purpose of the Study:

• To correlate cytomorphologic findings from bronchoalveolar lavage (BAL) with clinical symptoms in pediatric patients.
• To evaluate the utility of oil red O (ORO) staining in identifying lipid-laden macrophages (LLMs) in pediatric BAL samples.

Main Methods:

• A retrospective review of 100 pediatric patients who underwent BAL between 2014 and 2016.
• Analysis of patient demographics, clinical symptoms, cytomorphologic findings, and results of oil red O (ORO) and iron staining.

Main Results:

• The most common indications for BAL included cough, reflux, pneumonia, dysphagia, asthma, and cystic fibrosis.
• Cytomorphologic findings revealed acute inflammation in 37% and chronic inflammation in 9% of cases. Mucin, fungal, and viral elements were identified in a small subset of patients.
• Oil red O (ORO) staining for lipid-laden macrophages (LLMs) was positive in varying degrees in 55% of patients, with 25% showing negative staining.

Conclusions:

• Bronchoalveolar lavage (BAL) cytology is a valuable diagnostic tool for pediatric aerodigestive conditions.
• Oil red O (ORO) staining for lipid-laden macrophages (LLMs) can provide supplementary information in select pediatric cases.