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KMID : 0383820110710050322
Tuberculosis and Respiratory Diseases
2011 Volume.71 No. 5 p.322 ~ p.327
Value of Bronchoalveolar Lavage Fluid Cytology in the Diagnosis of Pneumocystis jirovecii Pneumonia: A Review of 30 Cases
Sung Ji-Youn

Han Joung-Ho
Oh Young-Lyun
Suh Gee-Young
Jeon Kyeong-Man
Kim Tae-Eun
Abstract
Background: Pneumocystis jirovecii is a fungus that has become an important cause of opportunistic infections. We present a summary of the clinical status and findings from bronchoalveolar lavage (BAL) of patients with Pneumocystis jirovecii pneumonia (PJP).

Materials and Methods : We selected 30 cases of PJP that were proven through a surgical specimen evaluation. BAL fluid cytology was reviewed, and agreement with the initial diagnosis was evaluated.

Results: All 30 cases of PJP occurred in immunocompromised patients. Only 15 of the 30 cases were initially diagnosed as PJP. We found PJP in 13 of the 15 cases that were negative at the initial diagnosis. The most characteristic finding of PJP was frothy exudates, and BAL fluid tended to show rare neutrophils. Two of seven patients with PJP and diffuse alveolar damage (DAD) revealed no frothy exudates in BAL fluid.

Conclusion: BAL fluid cytology was reconfirmed as a sensitive and rapid method to diagnose PJP. We must be aware of the possibility of PJP to maintain high diagnostic sensitivity. We cannot exclude PJP in cases of PJP with DAD, even if frothy exudates are not observed in the BAL fluid.
KEYWORD
Pneumocystis carinii, Pneumocystis jirovecii, Bronchoalveolar Lavage Fluid, Pathology
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