Diagnostic value of hemosiderin-containing macrophages in bronchoalveolar lavage

Abstract

Study objective: Our objective was to determine if the hemosiderin content of BAL macrophages allows us to draw any differential diagnostic conclusions in a variety of lung diseases.

Patients and study design: One hundred one patients who underwent BAL for different diagnostic reasons were studied prospectively.

Main results: The highest values for the hemosiderin score (HS) were found in patients with active alveolar hemorrhage and patients who had undergone heart transplantation for congestive heart failure. Compared to a control population, patients with Pneumocystis carinii pneumonia or invasive aspergillosis had a higher HS than patients with bacterial pneumonia or mycobacterial lung infection. High or intermediate values for HS were more often found in patients with a low than in those with a normal platelet count.

Conclusions: The differential diagnostic conclusions which can be based on an HS are limited.