Immune alveolitis in interstitial lung disease: an attractive cytological profile in immunocompromised patients - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles BMC Pulmonary Medicine Year : 2022

Immune alveolitis in interstitial lung disease: an attractive cytological profile in immunocompromised patients

Abstract

Background: Bronchoalveolar lavage (BAL) is a major diagnostic tool in interstitial lung disease (ILD). Its use remains largely quantitative, usually focused on cell differential ratio. However, cellular morphological features provide additional valuable information. The significance of the "immune alveolitis" cytological profile, characterized by lymphocytic alveolitis with activated lymphocytes and macrophages in epithelioid transformation or foamy macrophages desquamating in cohesive clusters with lymphocytes, remains unknown in ILD. Our objective was to describe patients' characteristics and diagnoses associated with an immune alveolitis profile in undiagnosed ILD. Methods: We performed a monocentric retrospective observational study. Eligible patients were adults undergoing diagnostic exploration for ILD and whose BAL fluid displayed an immune alveolitis profile. For each patient, we collected clinical, radiological and biological findings as well as the final etiology of ILD. Results: Between January 2012 and December 2018, 249 patients were included. Mean age was 57 ± 16 years, 140 patients (56%) were men, and 65% of patients were immunocompromised. The main etiological diagnosis was Pneumocystis pneumonia (PCP) (24%), followed by drug-induced lung disease (DILD) (20%), viral pneumonia (14%) and hypersensitivity pneumonitis (HP) (10%). All PCP were diagnosed in immunocompromised patients while HP was found in only 8% of this subgroup. DILD and viral pneumonia were also commonly diagnosed in immunocompromised patients (94% and 80%, respectively). Conclusion: Our study highlights the additional value of BAL qualitative description in ILD. We suggest incorporating the immune alveolitis profile for the diagnosis and management of ILD, especially in immunocompromised patients, since it guides towards specific diagnoses.
Fichier principal
Vignette du fichier
s12890-022-01871-w.pdf (1.02 Mo) Télécharger le fichier
Origin Publisher files allowed on an open archive

Dates and versions

inserm-03693149 , version 1 (10-06-2022)

Identifiers

Cite

Antoine Moui, Stéphanie Dirou, Christine Sagan, Renan Liberge, Claire Defrance, et al.. Immune alveolitis in interstitial lung disease: an attractive cytological profile in immunocompromised patients. BMC Pulmonary Medicine, 2022, 22 (1), pp.79. ⟨10.1186/s12890-022-01871-w⟩. ⟨inserm-03693149⟩
12 View
31 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More