Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
J Am Soc Cytopathol. 2022 Jul-Aug;11(4):226-233. doi: 10.1016/j.jasc.2022.04.005. Epub 2022 Apr 20.
Oil Red O staining is used for enumeration of the lipid-laden macrophage index (LLMI) as a surrogate for aspiration. As part of quality improvement efforts aimed at optimizing resource utilization, the utility of this stain in current cytopathology practice was re-evaluated. The objective of this study was to explore the clinical utility of Oil Red O staining in bronchoalveolar lavage (BAL) samples by correlating the LLMI with findings in concurrent histologic tissue samples.
Lung transbronchial biopsy specimens that suggested aspiration that were submitted with concurrent BAL cytology samples were retrieved. Lung tissue biopsies were reviewed for the presence of foamy alveolar macrophages (graded as 0, 1+, and 2+), foreign material, and giant cells. The concurrent BAL was reviewed with consensus determination of the LLMI.
A total of 53 cases were identified. On histology, 13 cases (24.5%) were found to have no foamy alveolar macrophages, 23 cases (43.4%) were found to have 1+ foamy alveolar macrophages, and 17 cases (32.1%) were found to have 2+ foamy alveolar macrophages. Six cases (11.3%) were found to have foreign material, and 10 cases (18.9%) were found to have multinucleated giant cells. The average LLMI score was 16, with 44 (83.0%) in the low range (LLMI <40) and 9 (17.0%) in the intermediate range (LLMI of 40-90).
None of the cases in our study had an LLMI that exceeded the cutoff value for which aspiration would be suspected. We found no correlation of the LLMI with lung biopsies that suggested aspiration.
油红 O 染色用于计数富含脂质的巨噬细胞指数（LLMI），作为抽吸的替代指标。作为旨在优化资源利用的质量改进努力的一部分，重新评估了这种染色在当前细胞病理学实践中的效用。本研究的目的是通过将 LLMI 与同时进行的组织学样本中的发现相关联，探讨油红 O 染色在支气管肺泡灌洗（BAL）样本中的临床应用。
检索了提示抽吸的经支气管肺活检标本，并同时附有 BAL 细胞学样本。对肺组织活检进行了泡沫状肺泡巨噬细胞（评为 0、1+和 2+）、异物和多核巨细胞的存在进行了审查。对同时进行的 BAL 进行了审查，并通过共识确定了 LLMI。
共确定了 53 例病例。在组织学上，13 例（24.5%）未发现泡沫状肺泡巨噬细胞，23 例（43.4%）发现 1+泡沫状肺泡巨噬细胞，17 例（32.1%）发现 2+泡沫状肺泡巨噬细胞。6 例（11.3%）发现有异物，10 例（18.9%）发现有多核巨细胞。平均 LLMI 评分为 16，其中 44 例（83.0%）处于低值（LLMI <40），9 例（17.0%）处于中值（LLMI 为 40-90）。
我们的研究中没有一个病例的 LLMI 超过怀疑抽吸的临界值。我们没有发现 LLMI 与提示抽吸的肺活检之间存在相关性。
