Abstract：
Oil Red O (ORO) positivity in bronchoalveolar lavage (BAL) fluid macrophages in the setting of e-cigarette, or vaping, product use-associated acute lung injury (EVALI) has been frequently requested by clinicians based on rare reports and subsequent US Centers for Disease Control and Prevention guidelines. The aim of this study was to determine the specificity of ORO staining in BAL specimens with disease states other than EVALI.
Consecutive BAL specimens (October-December 2019) were stained with ORO. The lipid-laden macrophage index (LLMI) was calculated for each case.
We studied BAL samples from 50 patients. Indications for BAL were surveillance bronchoscopy for lung transplantation (27/50), suspected infection (12/50), sarcoidosis/suspected sarcoidosis (3/50), nodules or ground-glass opacities (3/50), hemoptysis (2/50), asthma or eosinophilic pneumonia (2/50), and idiopathic pulmonary fibrosis (1/50). ORO staining was seen in BAL fluid macrophages in 45 of 50 cases (focal in 18, moderate in 23, diffuse in 4); LLMI ranged from 0 to 218. Using a threshold of LLMI of 85 or higher as positive, ORO was positive in 7 of 50 (14%) cases (range, 85-218).
ORO staining in BAL fluid macrophages is not specific for EVALI. Even when an LLMI of 85 or higher is used as a threshold for positivity, ORO positivity occurs in a significant subset of non-vaping-related cases.
Consecutive BAL specimens (October-December 2019) were stained with ORO. The lipid-laden macrophage index (LLMI) was calculated for each case.
We studied BAL samples from 50 patients. Indications for BAL were surveillance bronchoscopy for lung transplantation (27/50), suspected infection (12/50), sarcoidosis/suspected sarcoidosis (3/50), nodules or ground-glass opacities (3/50), hemoptysis (2/50), asthma or eosinophilic pneumonia (2/50), and idiopathic pulmonary fibrosis (1/50). ORO staining was seen in BAL fluid macrophages in 45 of 50 cases (focal in 18, moderate in 23, diffuse in 4); LLMI ranged from 0 to 218. Using a threshold of LLMI of 85 or higher as positive, ORO was positive in 7 of 50 (14%) cases (range, 85-218).
ORO staining in BAL fluid macrophages is not specific for EVALI. Even when an LLMI of 85 or higher is used as a threshold for positivity, ORO positivity occurs in a significant subset of non-vaping-related cases.
摘要：
在电子烟的背景下，支气管肺泡灌洗（BAL）液巨噬细胞中的油红O（ORO）阳性，或vaping，根据罕见的报告和随后的美国疾病控制和预防中心指南，临床医生经常要求与产品使用相关的急性肺损伤(EVALI)。这项研究的目的是确定ORO染色在具有EVALI以外的疾病状态的BAL标本中的特异性。
连续BAL标本（2019年10月至12月）用ORO染色。计算每种情况下的脂质负载巨噬细胞指数（LLMI）。
我们研究了50名患者的BAL样本。BAL的适应症是肺移植的监测支气管镜检查（27/50），疑似感染（12/50），结节病/疑似结节病（3/50），结节或毛玻璃混浊（3/50），咯血（2/50），哮喘或嗜酸性粒细胞肺炎（2/50），和特发性肺纤维化（1/50）。50例中有45例BAL液巨噬细胞可见ORO染色（局灶性18例，中度23例，弥漫性4例）；LLMI范围为0至218。使用85或更高的LLMI阈值为正，ORO在50例中的7例（14%）中呈阳性（范围，85-218).
BAL液巨噬细胞中的ORO染色对EVALI不是特异性的。即使使用85或更高的LLMI作为阳性阈值，ORO阳性发生在非蒸发相关病例的重要子集。
连续BAL标本（2019年10月至12月）用ORO染色。计算每种情况下的脂质负载巨噬细胞指数（LLMI）。
我们研究了50名患者的BAL样本。BAL的适应症是肺移植的监测支气管镜检查（27/50），疑似感染（12/50），结节病/疑似结节病（3/50），结节或毛玻璃混浊（3/50），咯血（2/50），哮喘或嗜酸性粒细胞肺炎（2/50），和特发性肺纤维化（1/50）。50例中有45例BAL液巨噬细胞可见ORO染色（局灶性18例，中度23例，弥漫性4例）；LLMI范围为0至218。使用85或更高的LLMI阈值为正，ORO在50例中的7例（14%）中呈阳性（范围，85-218).
BAL液巨噬细胞中的ORO染色对EVALI不是特异性的。即使使用85或更高的LLMI作为阳性阈值，ORO阳性发生在非蒸发相关病例的重要子集。
