Significance of Oil-Red-O positive macrophages in bronchoalveolar lavage in diagnosing E-cigarettes or vaping product use-associated lung injury: A case series.
Adolescent
Adult
Azo Compounds
Bronchoalveolar Lavage Fluid
/ cytology
Coloring Agents
E-Cigarette Vapor
/ adverse effects
Electronic Nicotine Delivery Systems
Female
Humans
Lung Injury
/ diagnosis
Macrophages
/ metabolism
Male
Sensitivity and Specificity
Staining and Labeling
/ methods
Vaping
/ adverse effects
Young Adult
E-cigarette
Oil-Red-O
bronchoalveolar lavage
lipid-laden macrophage
lung injury
vaping
Journal
Diagnostic cytopathology
ISSN: 1097-0339
Titre abrégé: Diagn Cytopathol
Pays: United States
ID NLM: 8506895
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
12
04
2021
received:
01
12
2020
accepted:
19
04
2021
pubmed:
27
4
2021
medline:
15
12
2021
entrez:
26
4
2021
Statut:
ppublish
Résumé
Lipid-laden macrophages detected by Oil-Red-O (ORO) stain in fresh bronchoalveolar lavage (BAL) specimens have been proposed as a potential diagnostic marker for E-cigarettes or vaping product use-associated lung injury (EVALI). However, studies are few, and the sensitivity and specificity of the test have not been thoroughly investigated. We performed ORO stain on fresh BAL specimens from six confirmed EVALI and 36 non-EVALI patients. After semi-quantitative analysis, the sensitivity and specificity of ORO-positive macrophages (OPM) for detection of EVALI were calculated. No significant difference in cytomorphology or raw macrophage count was observed between EVALI and non-EVALI groups (49% vs 55% of all nucleated cells). However, with ORO stain, all EVALI specimens (6/6) showed a high percentage (≥50% of all macrophages) of OPM (mean 87%), and large (≥25% of host macrophage nuclear size) lipid droplets (mean 42%), while the majority of non-EVALI specimens showed a low percentage of OPM (32/36, mean 10%), and small lipid droplets (34/36, mean 6%). The differences between the two groups in both high OPM and large lipid droplet rates are statistically significant (P < .0001 for both comparisons). The combined sensitivity and specificity of high OPM and large lipid droplets for diagnosing EVALI were 100% and 94%, respectively. In BAL specimens obtained from patients with clinically suspected EVALI, a high percentage of OPM with large lipid droplets showed high sensitivity and specificity for the diagnosis of EVALI and may serve as a potentially useful tool in the evaluation of vaping-related lung injury, improving diagnostic accuracy.
Sections du résumé
BACKGROUND
BACKGROUND
Lipid-laden macrophages detected by Oil-Red-O (ORO) stain in fresh bronchoalveolar lavage (BAL) specimens have been proposed as a potential diagnostic marker for E-cigarettes or vaping product use-associated lung injury (EVALI). However, studies are few, and the sensitivity and specificity of the test have not been thoroughly investigated.
METHODS
METHODS
We performed ORO stain on fresh BAL specimens from six confirmed EVALI and 36 non-EVALI patients. After semi-quantitative analysis, the sensitivity and specificity of ORO-positive macrophages (OPM) for detection of EVALI were calculated.
RESULTS
RESULTS
No significant difference in cytomorphology or raw macrophage count was observed between EVALI and non-EVALI groups (49% vs 55% of all nucleated cells). However, with ORO stain, all EVALI specimens (6/6) showed a high percentage (≥50% of all macrophages) of OPM (mean 87%), and large (≥25% of host macrophage nuclear size) lipid droplets (mean 42%), while the majority of non-EVALI specimens showed a low percentage of OPM (32/36, mean 10%), and small lipid droplets (34/36, mean 6%). The differences between the two groups in both high OPM and large lipid droplet rates are statistically significant (P < .0001 for both comparisons). The combined sensitivity and specificity of high OPM and large lipid droplets for diagnosing EVALI were 100% and 94%, respectively.
CONCLUSION
CONCLUSIONS
In BAL specimens obtained from patients with clinically suspected EVALI, a high percentage of OPM with large lipid droplets showed high sensitivity and specificity for the diagnosis of EVALI and may serve as a potentially useful tool in the evaluation of vaping-related lung injury, improving diagnostic accuracy.
Substances chimiques
Azo Compounds
0
Coloring Agents
0
E-Cigarette Vapor
0
oil red O
G7S71FND9B
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
876-884Subventions
Organisme : University of Texas Southwestern Medical Center
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping Products February 2019. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html.
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