Drak Alsibai Kinan, Aissaoui Houari, Adenis Antoine, Bourne-Watrin Morgane, Djossou Felix, Epelboin Loïc, Blanchet Denis, Demar Magalie, Couppié Pierre, Nacher Mathieu
Department of Pathology, Centre Hospitalier de Cayenne Andrée Rosemon, 97300 Guiana, France.
Center of Biological Resource (CRB Amazonie), Centre Hospitalier de Cayenne Andrée Rosemon, 97300 Guiana, France.
J Fungi (Basel). 2021 Jul 19;7(7):576. doi: 10.3390/jof7070576.
Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to describe the cytology of histoplasmosis diagnosed by bronchoalveolar lavage (BAL) in relation to patient characteristics. BAL-diagnosed pulmonary histoplasmosis concerned 17 patients (14 HIV+). BAL cellularity ranged from 76,000 to 125,000 cells/mL in HIV patients, and 117,000 to 160,000 cells/mL in non-HIV patients. Macrophages predominated in all HIV patients (from 60% to 88%), lymphocytic infiltrates ranged from 5% to 15%, and neutrophils were very heterogeneous (from 2% to 32%). The number of at hot spots seemed greater in HIV-infected than in immunocompetent patients (9 to 375 vs. 4 to 10) and were inversely proportional to the CD4 counts. Yeasts were both intracellular and extracellular in 85.7% of the HIV patients. This is the most comprehensive series detailing the cytological aspects of BAL in the diagnosis of , focusing on the number of yeasts and their clustering pattern. The cytological examination of the Gomori-Grocott-stained BAL allows a reliable diagnosis of histoplasmosis.
播散性组织胞浆菌病是HIV感染患者死亡的主要原因。快速有效的诊断至关重要。大多数医院都可进行细胞病理学检查，这是一种快速的诊断方法。在本研究中，我们回顾了12年的经验，以描述通过支气管肺泡灌洗（BAL）诊断的组织胞浆菌病的细胞学与患者特征的关系。BAL诊断的肺组织胞浆菌病涉及17例患者（14例HIV阳性）。HIV患者的BAL细胞计数范围为76,000至125,000个细胞/毫升，非HIV患者为117,000至160,000个细胞/毫升。所有HIV患者中巨噬细胞占主导（60%至88%），淋巴细胞浸润范围为5%至15%，中性粒细胞差异很大（2%至32%）。HIV感染患者热点处的酵母数量似乎比免疫功能正常的患者更多（9至375个对4至10个），且与CD4细胞计数成反比。85.7%的HIV患者中酵母存在于细胞内和细胞外。这是最全面的系列研究，详细阐述了BAL在组织胞浆菌病诊断中的细胞学方面，重点关注酵母数量及其聚集模式。对Gomori-Grocott染色的BAL进行细胞学检查可对组织胞浆菌病做出可靠诊断。
