Diagnostic utility of sputum cytology in pneumocystis carinii pneumonia in acquired immunodeficiency syndrome (AIDS)

Abstract

Diagnostic utility of cytological examination of sputum in patients with pneumocystic carinii (PC) pneumonia in AIDS was evaluated in comparison with PC pneumonia with hematological disorders. In one case examination was done by bronchoalveolar lavage (BAL), and in 9 by sputum. In BAL case and 7 out of 9 by sputum, cysts of PC were detected. The cysts were clearly demonstrated by Grocott methenamin silver stain. On Papanicolaou stain, they were faintly eosino philic and appeared as ring shape. Other hallmark for PC pneumonia was foamy substance stained by light green, which was consistent with intraalveolar foamy exudate demonstrated in the lung at autopsy. The cysts were in foamy substance in BAL or in cases with abundant foamy material. But in most cases, they were evidenced apart from foamy substance in the background. There was no correlation between the number of cysts demonstrated in sputum and the amount of foamy substance or histiocytes in the background. On the contrary 8 out of 9 PC pneumonia in hematological disorders were diagnosed only by BAL. Thus the sputum cytology is usefull for the detection of PC in AIDS.