ILD- Broncheoalveolar Lavage

Question 1

CD4:CD8 ratio > 3.5 most specific diagnosis; lymphocytosis

Answer 1

Sarcoidosis

Question 2

Hemosiderin-laden macrophages, red blood cells

Answer 2

Diffuse alveolar bleeding

Question 3

Marked lymohocytosis > 50%

Answer 3

Hypersensitivity pneumonitis

Question 4

Atypical hyperplastic type II pneumocytes

Answer 4

Diffuse alveolar damage

Drug Toxicity

Question 5

Pneumocystis carinii, fungi, CMV transformed cells

Answer 5

Opportunistic infections

Question 6

Milky effluent, foamy macrophages and lipoproteinaceous intraalveolar material (periodic acid schiff stain- positive)

Answer 6

Alveolar proteinosis

Question 7

Increased CD1+ Langerhans cells, electron microscopy demonstrating Birbeck granule in lavaged macrophage (expensive and difficult to perform)

Answer 7

Pulmonary Langerhans cell histiocytosis

Question 8

Dust particles by polarized light microscopy

Answer 8

Silicosis

Question 9

Accumulation of specific lipopigment in alveolar macrophages

Answer 9

Lipoidosis

Question 10

Foamy macrophages, mixed pattern of increased cells characteristic, decreased CD4:CD8 ratio

Answer 10

Organizing pneumonia

Question 11

Eosinophils > 25%

Answer 11

Eosinophilic Lung Disease

Question 12

Fat globules in macrophages

Answer 12

Lipoid pneumonia

Question 13

Dust particles, ferruginous bodies

Answer 13

Asbestos related pulmonary disease

Question 14

Malignant cells

Answer 14

Lymphangitic carcinomatosis
Alveolar cell carcinoma
Pulmonary lymphoma