Examination included the findings of 141 patients with various granulomatous pulmonary diseases: tuberculosis (26), sarcoidosis (100) and exogenous-allergic alveolitis (15). The biopsy specimens were divided into 3 groups depending on the nature of changes: (1) the presence of epithelioid-cellular granulomas (EG) (80); (2) fibrous changes (47); (3) caseous detritus (14). Patients with EG in the biopsy specimens had mean lymphocytosis of 41.3 +/- 6% in bronchoalveolar washings (BAW) in all granulomatous diseases. Correlation between the cellular BAW composition and cytomorphologic pattern of the biopsy specimens has revealed more stable links between the presence of EG in biopsy specimens and lymphocytosis in BAW in tuberculosis, sarcoidosis and endogenous-allergic alveolitis. Tuberculosis patients, in addition to lymphocytosis in BAW, have increased neutrophils which depended on the degree of exudative-necrotic reactions that accompanied the formation of tuberculous granulomas. Patients with fibrous changes in the biopsy specimens had varying increases in neutrophil counts in BAW (11.7 +/- 2.3%). The lymphocyte count in BAW in the presence of caseous detritus in the biopsy specimens in tuberculosis in the absence of granulomas decreased (47.8 +/- 7.5 and 12.5 +/- 3.3%) and the neutrophil count increased (20.6 +/- 6.3 and 24.9 +/- 6.9%).
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