Sharma S, Gupta P, Gupta N, Lal A, Behera D, Rajwanshi A
Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cytopathology. 2017 Feb;28(1):46-54. doi: 10.1111/cyt.12359. Epub 2016 Jun 13.
To evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of pulmonary infections in immunocompromised patients and to identify the imaging pattern of infections on computed tomography (CT).
This was a retrospective study of 42 immunocompromised patients who underwent FNAC under image guidance owing to a clinical pulmonary infection. Each patient was evaluated for an underlying immunocompromised condition, cytological diagnosis, CT findings and complications.
The most common predisposing condition was diabetes mellitus (n = 11), renal transplant status (n = 11) followed by connective tissue disorders (n = 6) and malignancy (n = 5). There were four patients with renal disease and three had a human immunodeficiency virus (HIV) infection. The most common cytological diagnosis was mucormycosis (n = 13) followed by nocardiosis (n = 8) and necrotising inflammation (n = 7), tuberculosis (n = 6), cryptococcosis (n = 2), aspergillosis(n = 2), histoplasmosis(n = 1) and atypical mycobacterial infection (n = 1). Mucormycosis presented as a pulmonary nodule (n = 7), mass lesion (n = 5) or consolidation (n = 4). The patients with nocardiosis had lung nodules with associated consolidation and cavitation. None of the patients had any major complication.
FNA is a relatively reliable, safe and quick method of diagnosing pulmonary infection in immunocompromised patients. Cytomorphological features, when aided by special stains, can accurately detect the specific infection which is potentially treatable. Specific infections may be suggested based on specific imaging patterns.
评估细针穿刺细胞学检查（FNAC）在免疫功能低下患者肺部感染诊断中的作用，并确定计算机断层扫描（CT）上感染的影像学表现。
这是一项对42例因临床肺部感染在影像引导下接受FNAC检查的免疫功能低下患者的回顾性研究。对每位患者进行潜在免疫功能低下状况、细胞学诊断、CT表现及并发症的评估。
最常见的易感因素是糖尿病（n = 11）、肾移植状态（n = 11），其次是结缔组织病（n = 6）和恶性肿瘤（n = 5）。有4例肾病患者，3例人类免疫缺陷病毒（HIV）感染患者。最常见的细胞学诊断是毛霉菌病（n = 13），其次是诺卡菌病（n = 8）和坏死性炎症（n = 7）、结核病（n = 6）、隐球菌病（n = 2）、曲霉菌病（n = 2）、组织胞浆菌病（n = 1）和非典型分枝杆菌感染（n = 1）。毛霉菌病表现为肺结节（n = 7）、肿块病变（n = 5）或实变（n = 4）。诺卡菌病患者的肺部结节伴有实变和空洞形成。所有患者均未出现任何严重并发症。
FNA是诊断免疫功能低下患者肺部感染的一种相对可靠、安全且快速的方法。细胞形态学特征在特殊染色的辅助下，可准确检测出潜在可治疗的特定感染。基于特定的影像学表现可提示特定感染。
