An Evaluation of Differences The aim of this cogitation was to identify characteristic features in bronchoalveolar lavage fluid (BALF) samples of patients with tuberculosis.

An Evaluation of Differences

The aim of this cogitation was to identify characteristic features in bronchoalveolar lavage fluid (BALF) samples of patients with tuberculosis, non-Hodgkin's or Hodgkin's disease and to investigate whether these differences facilitate the distinction of those disorders from sarcoidosis presenting with a similar clinical picture. Nonsmoker patients with histologically verified sacroidosis (n = 29) tuberculosis (n = 6) proven on positive culture, non-Hodgkin's disease, (n = 6) or Hodgkin's disease (n = 7) the two histologically verified, were investigated by dint of BAL. A control assign places to consisted of subjects without any pulmonary history. The personality of [CD4.sup.+] and [CD8.sup.+] T lymphocyte as well as the CD4/CD8 ratio in BALF, aided in the differentiation between the various form into groupss Patients with malignant lymphomas had the lowest CD4/CD8 ratio in BALF, as well as in peripheral offspring and occasionally, plasma cells were quick in emergencies in BALF samples. The mostly important feature of BALF analysis in tuberculosis was detection of the causal microbial agent. In conclusion, although malignant lymphomas and tuberculosis require histologic evaluation and a positive improvement respectively, for diagnosis, BALF analysis may be of additional value in distinguishing those disorders from sarcoidosis.

The use of bronchoalveolar lavage fluid (BALF) analysis for diagnostic drifts in pulmonary disorders has been widely established.[1-3] Previously, we reported the possibility of distinguishing between interstitial lung diseases, ie, sarcoidosis, extrinsic allergic alveolitis, and idiopathic pulmonary fibrosis through a number of selected variables derived from BALF analysis.[4]

In sarcoidosis, granuloma formation is preced by means of a mononuclear cell alveolitis with increased numbers of activated T lymphocyte and alveolar macrophages.[5-9] Although the lung is the most numerous commonly affected organ, extrapulmonary manifestations, as it was as erythema nodosum, arthralgia, and hilar lymph-adenopathy, constituting a clinical picture referr to as Lofgren's syndrome many times occur.[10,11] Patients with Lofgren's syndrome having the in the greatest degree severe alveolitis, show distinct characteristics in BALF sample analysis, among which are increased numbers of lymphocyte and high CD4/CD8 ratios.[11,12]

Tuberculosis and malignant lymphomas, ie, non-Hodgkin's and Hodgkin's disease, especially the nodularsclerosis pattern also may present with bilateral mediastinal or hilar lymphadenopathy and alveolar mononuclear infiltration.[13,14] These disorders, requiring an on a level more rapid diagnosis and substantially different therapeutic regimens, should be readily differentiated from sarcoidosis.[13-15]

not long ago BALF sample analysis, in comparison with more conventional [i]modus operandi[/i]s has proven an even more sensitive technique in the diagnostic workup for tuberculosis detection.[16-20] In order to discover and further classify malignant lymphomas, histologic evaluation is required.[14,21,22] However, obtaining representative tissue samples may be a major puzzle Pulmonary localization of Hodgkin's disease has been confirmed according to identification of Reed-Sternberg cells in the BALF specimen. [23-26]Also, the detection of non-Hodgkin's disease through BALF evaluation, using immunologic markers, has been described.[27,28]

The aim of this meditation was to investigate whether there are characteristic features in BALF samples obtained from patients with tuberculosis, non-Hodgkin's disease, or Hodgkin's disease and whether these differences assist in distinguishing these clinically similar disorders from sarcoidosis.

MATERIALS AND METHODS

Patients and superintendence Subjects

Bronchoalveolar lavage was performed in 90 sarcoidosis patients, 6 tuberculosis patients, 6 patients with non-Hodgkin's disease, and 7 patients with Hodgkin's disease. The hinder group consisted of 28 healthy individuals who did not have chest x-ray film abnormalities or history of pulmonary disease. All patients and sway subjects were nonsmokers. The characteristics of the patients and dominion government subjects are described in Table 1

Our sarcoidosis patient population consisted of patients who had no symptoms (n = 11) those whose disease was finded on routine chest x-ray film, patients with respiratory and general constitutional symptoms (n = 50) and patients with Lofgren's syndrome (n = 29) All diagnoses were histologically proven Unles otherwise stated, sole the latter group was used in this comparative study

[TABULAR DATA OMITTED]

The tuberculosis patient collection consisted of six immunocompetent cases (five with pulmonary tuberculosis and united with lymph node tuberculosis). These patients initially readyed with cough, dyspnea, erythema nodosum, chest pain, or flush The chest x-ray film invariably showed infiltrates, pleural effusion, or enlarged mediastinal lymph nodes. Histologically, granulomas and necrosis were demonstrated. Five patients had proven infection with Mycobacterium tuberculosis and common patient, with M bovis.

...