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Comparison of the diagnostic value of different lymphocyte subpopulations in bronchoalveolar lavage fluid in patients with biopsy proven sarcoidosis

Tanriverdi H. | Uygur F. | Örnek T. | Erboy F. | Altinsoy B. | Atalay F. | Büyükuysal M.Ç.

Article | 2015 | Sarcoidosis Vasculitis and Diffuse Lung Diseases32 ( 4 ) , pp.305 - 312

Background: Bronchoalveolar lavage is considered a helpful tool in the diagnosis of diffuse parenchimal lung diseases such as sarcoidosis. CD4/CD8 ratio is higly specific but not sensitive to distinguish sarcoidosis and other intestitial lung diseases. We aimed to compare the diagnostic value of CD4/CD8 ratio and other lmphocyte subpopulations such as CD3+16+56, CD103+, CD4+CD103+, CD8+CD103+ in bronchoalveolar lavage to distinguish sarcoidosis and other nonsarcoidosis interstitial lung diseases. Methods: Using the bronchoscopy records from 2006 to 2013, we evaluated 68 patients with biopsy proven sarcoidosis and 72 patients with cl . . .inicoradiological and/or biopsy proven diffuse parenchimal lung diseases. Cut off values, sensitivity and specificity were given for aforementioned parameters. Results: Bronchoalveolar lavage CD4/CD8 ratio, CD4+ T lymphocyte percentage, CD4+103+, CD3+CD103-, CD8+CD103+/CD103+ ratio were significantly higher in sarcoidosis than other diffuse parenchimal lung diseases whereas CD3+103+, CD3+16+56+, CD8+, CD8+CD103+, CD8+CD103+/CD8+ were significantly lower. Best cut off value of CD4/CD8 was 1.34 with sensitivity and specificity 76.4%, 79.4% respectively. The cut off values of CD4/CD8 of >3.5 and >2.5 had specificity 95.9% and 95.3%, respectively and sensitivity 52%, 41 %, respectively. Conclusion: CD4/CD8 ratio is highly specific but not sensitive for sarcoidosis diagnosis. Thus, BAL flow cytometry is not diagnostic alone without appropriate clinicoradiological and/or histopathological findings. © Mattioli 1885 Daha fazlası Daha az

Comparison of the diagnostic results of bronchoalveolar lavage with synchronous transbronchial biopsies [Bronkoalveoler lavaj-transbronşiyal biyopsi tanilarinin karşilaştirilmasi]

Barut F. | Özdamar Ş.O. | Bahadir B. | Dogan Gün B. | Bektaş S. | Çolak S. | Mocan Kuzey G.

Article | 2007 | Turkiye Klinikleri Journal of Medical Sciences27 ( 2 ) , pp.179 - 183

Objective: Bronchoalveolar lavage performed during bronchoscopic examination is a type of cytologic sampling with great diagnostic significance. Its diagnostic value is enhanced when biopsy is unavailable and bronchoalveolar lavage is the unique sample. Determining the diagnostic accuracy of bronchoalveolar lavage by comparing it with the diagnostic yield of synchronous biopsies is an indicator of its effectiveness. Material and Methods: In this study, 435 bronchoalveolar lavage and 273 bronchoscopic biopsy specimens obtained from January 2003 to December 2005 in the Department of Pulmonary Diseases were retrospectively evaluated in . . . the Department of Pathology, Faculty of Medicine, Zonguldak Karaelmas University. Results: Overall, 373 cases (85.8%) were diagnosed as benign and 12 cases (2.8%) were reported as malignant, while 18 cases (4.1%) were suspected to be malignant; the remaining 32 cases (7.3%) were reported as inadequate. The numbers and percentages of benign, malignant, suspected malignant and inadequate diagnoses of the 273 bronchoalveolar lavage cases with synchronous transbronchial biopsies were 229 (83.9%), 12 (4.5%), 16 (5.8%), and 16 (5.8%), respectively. After suspected malignant and inadequate samples were excluded, coomparison of cytologic and histologic diagnoses revealed that the diagnostic accuracy of bronchoalveolar lavage cytology was 79.4% and 91.6% for benign and malignant diagnoses, respectively; the rate of false negativity was 20.5% and false positivity was 8.3%. Conclusion: While sampling errors seemed to be the primary reason for false negative and false positive diagnoses, the rate of false cytologic evaluation was lower. Considering the false negative diagnoses for cases without biopsy specimens, comparison of bronchoalveolar lavage diagnoses with synchronous biopsies may serve as a quality control programme, since this condition may significantly influence the clinical course. Copyright © 2007 by Türkiye Klinikleri Daha fazlası Daha az

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