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- 请教-肺泡灌洗液
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Those cells are alveolar macrophage. Some people call them pulmonary macrophages. They are neither columnar bronchial epithelial cells nor squamous cells. Normal.
We need to see abundant alveolar macrophages or bronchial epithelial cells to call a bronchial wash adequate.
| 以下是引用mingfuyu在2008-7-15 7:47:00的发言：
Those cells are alveolar macrophage. Some people call them pulmonary macrophages. They are neither columnar bronchial epithelial cells nor squamous cells. Normal. We need to see abundant alveolar macrophages or bronchial epithelial cells to call a bronchial wash adequate. |
谢谢mingfuyu老师的回复！
只是有些不懂之处：
We need to see abundant alveolar macrophages or bronchial epithelial cells to call a bronchial wash adequate.
这句话是说只有看到大量的肺泡巨噬细胞或支气管上皮细胞才算成功的肺泡灌洗吗？但看见这么大量的肺泡巨噬细胞应该不能算正常吧，会提示什么疾病呢？脱屑性肺炎、间质性肺炎或其它？该患儿病情进展较快，胸片提示已有间质纤维化。
非常感谢！
To 10th floor:
We almost always assess adequacy first with cytology specimens. The quantity of alveolar macrophages do not suggest any specific disease, or any disease. I have seen inumerable bronchial washings with viarible alveolar macrophage, some with really abundant cells during my training and my practice, never called it anything. I have attended many cytopath conferences and also never heard anybody mentioned any significance of the quantity of cells in bronchial washings.
Cytology helps clinicians and patients many times. But i quess this is the time the bronch wash didn't help much, besides negative findings. We usually look for malignant cells, microorganisms (fungi (don't confuse with oral contaminants) even viral cytopathic effects), occasionally foreign material or food particles suggesting aspiration pneumonia. I also report inflammatory cells if i see.
| 以下是引用mingfuyu在2008-7-17 8:06:00的发言：
To 10th floor: We almost always assess adequacy first with cytology specimens. The quantity of alveolar macrophages do not suggest any specific disease, or any disease. I have seen inumerable bronchial washings with viarible alveolar macrophage, some with really abundant cells during my training and my practice, never called it anything. I have attended many cytopath conferences and also never heard anybody mentioned any significance of the quantity of cells in bronchial washings. Cytology helps clinicians and patients many times. But i quess this is the time the bronch wash didn't help much, besides negative findings. We usually look for malignant cells, microorganisms (fungi (don't confuse with oral contaminants) even viral cytopathic effects), occasionally foreign material or food particles suggesting aspiration pneumonia. I also report inflammatory cells if i see. |
非常感谢mingfuyu老师的解答，学习了！
老师说：细胞学标本需首先评价细胞是否足够。肺泡巨噬细胞的数量并不提示任何疾病。在我接受训练和从业过程中阅过大量支气管灌洗液，其中可见多少不等的肺泡巨噬细胞，有时候是大量的，但从不提示什么。我也参加过许过细胞学学术会议，也从来没人说过这些细胞的意义。
细胞学往往会给临床医生或病人以帮助，但支气管灌洗液却不然。我们通常会寻找其中的恶性细胞、病原微生物（真菌（需与口腔污染菌区分）或病毒）、异物或食物残渣提示吸入性肺炎，或者炎性细胞。
