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.
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。