Derrame pleural rentabilidad de la biopsia pleural con aguja / Advantages of pleural reedle biopsy in pleural effusion

Se presentan 87 casos de derrame pleural que comprenden el periodo 1990-1991 de las internaciones de la CNS. Las causas mas frecuentes fueron TBC 32 casos (36,8//) neoplasias 25 (28,7//) metaneumonicos 7 (8//) insuficiencia cardiaca 7 (8//) insuficiencia renal 4 (4,6//), cirrosis hepatica 1 caso (1,15//) y hemotorax traumatico 1 caso (1,15//). En 10 de ellos (11,5//) no se llego al diagnostico etiologico por falta de seguimiento. El porcentaje de resultados positivos (sensibilidad) de la toracocentesis y biopsia pleural alcanzo a 66// en la pleuritis tuberculosa al 56// en los derrames neoplasicos y, considerando ambas patologias en conjunto alcanzo al 61//.

Utilidad diagnostica de una segunda toracocentesis y biopsia pleural realizada a pacientes con estudio previo negativo; analisis de 21 casos / Diagnostic utility of the second thoracocentesis and pleural biopsy in a patient with previous negative study; analisys of 21 cases

Se realiza un estudio de sensibilidad y utilidad diagnostica de una segunda toracocentesis y biopsia pleural, encontrandose una mejora significativa y un aumento del valor predictivo de la tecnica.

Identification of mast cells in bronchoalveolar lavage fluid. Comparison between different fixation and staining methods.

The present study was carried out to compare the effectiveness of different fixation and staining methods in the identification of mast cells obtained by bronchoalveolar lavage from patients with interstitial lung diseases. Cell preparations were fixed with formaldehyde or methanol. Mast cells were identified by metachromatic staining with May Grünwald Giemsa, Toluidine blue or Gallamine blue Giemsa. After formaldehyde fixation only a few mast cells were identified, regardless of the stain method used. In contrast, a significantly higher number of mast cells were observed after methanol fixation. Using this fixative, Toluidine blue stain showed a higher number of mast cells than May Grünwald Giemsa. However, there was no difference between Toluidine and Gallamine blue Giemsa in the number of cells observed. The easy identification of mast cells after staining with toluidine, combined with its easy application, suggest that Toluidine blue stain after methanol fixation is the most useful method for determining the presence of mast cells in lavage fluid.

[Significance of the presence of mastocytes in bronchoalveolar lavage in the diagnostic evaluation of diffuse interstitial lung diseases]. / Significado de la presencia de mastocitos en el lavado broncoalveolar en la valoración diagnóstica de las enfermedades pulmonares intersticiales difusas.

The cell preparations of 199 bronchoalveolar lavages (BAL) were reviewed to evaluate the meaning of the presence of mastocytes for the diagnosis of diffuse interstitial lung diseases. The study population consisted of 41 control individuals, 10 with extrinsic allergic alveolitis (EAA), 55 with sarcoidosis 38 with asbestosis, 25 with pulmonary fibrosis associated to collagen diseases, 18 with idiopathic pulmonary fibrosis and 12 with carcinomatous lymphangitis. Mastocytes were predominantly found in patients with EAA (8 of 10 cases) and in some cases of sarcoidosis and idiopathic pulmonary fibrosis. The rate of mastocytes in the patients with EAA was significantly higher than in the other groups (p less than 0.001). The presence of mastocytes in the BAL is particularly suggestive of EAA; rates higher than 3% are only found in this condition.