Diagnostic value of hemosiderin-containing macrophages in bronchoalveolar lavage.

STUDY OBJECTIVE

Our objective was to determine if the hemosiderin content of BAL macrophages allows us to draw any differential diagnostic conclusions in a variety of lung diseases.

PATIENTS AND STUDY DESIGN

One hundred one patients who underwent BAL for different diagnostic reasons were studied prospectively.

MAIN RESULTS

The highest values for the hemosiderin score (HS) were found in patients with active alveolar hemorrhage and patients who had undergone heart transplantation for congestive heart failure. Compared to a control population, patients with Pneumocystis carinii pneumonia or invasive aspergillosis had a higher HS than patients with bacterial pneumonia or mycobacterial lung infection. High or intermediate values for HS were more often found in patients with a low than in those with a normal platelet count.

CONCLUSIONS

The differential diagnostic conclusions which can be based on an HS are limited.