532例艾滋病患者支气管肺泡灌洗液细胞病理学分析

Cytopathological findings of bronchoalveolar lavage fluid in AIDS patients:a serial of 532 cases anelysis

目的研究艾滋病(AIDS)患者支气管肺泡灌洗液(BALF)的病理改变及特点。方法收集2008年-10月—2014年-05日间北京地坛医院532例艾滋病患者BALF标本采用Thin Prep液基细胞学技术涂片后行HEPAS、六胺银(GMS)和抗酸染色。结果 532例艾滋病患者BALF标本细胞学涂片中查见病变者178例(33.5%);包括卡氏肺囊虫116例、分枝杆菌27例、真菌19例、CMV2例、复合感染9例,另外有肿瘤5例。结论目前国内AIDS相关肺部疾病以卡氏肺囊虫及结核感染为主,细胞病理学检查为AIDS相关肺部疾病诊断提供方便快捷的形态学依据,有重要临床应用价值。

Objective To study and analyze the cytopathologic features of bronchoalveolar lavage fluid （BALF） in the diagnosis of AIDS-related lung disease. Methods BALF specimens from 532 cases of AIDS patients were collected in Beijing Ditan Hospital from October 2008 to May 2014. Cytologic smears were prepared by using ThinPrep cytology method with HE staining, periodic acid Schiff （PAS）, Gomori＇ s methenamine silver （GMS） and acid fast stains and immunohistochemistry. Results 178 cases were tound positive in 532 cases, accounting for 33.5% of the total cases. These included 116 cases of pneumocystis, 27 cases of Mycobacterium infection, 19 cases of fungus infection, 2 cases of CMV, and 9 cases of compound infections. In addition, there were neoplastic ceils in 5 cases. Conclusion Pneumocystis carinii infection and tuberculosis are main findings in AIDS-related lung disease at present. Cytopathology can provide morphological evidences in the diagnosis of AIDS-related lung disease. It has important clinical value.