The American review of respiratory disease
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Histologic findings from segmental lavage material via the fiberoptic bronchoscope were evaluated as a means of diagnosing pulmonary alveolar proteinosis. Active cases of alveolar proteinosis yielded grossly opaque and/or milky effluents. The unique histologic findings in alveolar proteinosis included: (1) very few alveolar macrophages (2) large acellular eosinophilic bodies in a diffuse background of eosinophilic granules, and (3) periodic acid-Schiff staining of the proteinaceous material with a lack of significant alcian blue staining. Thus, the diagnosis of pulmonary alveolar proteinosis can be made by evaluation of the clinical setting and histologic findings of the effluent material from a segmental lavage.
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Am. Rev. Respir. Dis. · May 1980
Observations on pleural fluid pressures as fluid is withdrawn during thoracentesis.
In 52 patients with pleural effusions, pleural pressures were measured initially and serially as pleural fluid was withdrawn. Pleural fluid aspiration was continued until the pleural pressure fell below -20 cmH2O, or the patient developed excessive symptoms, or no more fluid could be obtained. The initial pleural pressure ranged from +8 to -21 cmH2O. ⋯ Negative initial pleural pressures and/or rapid changes in the pressures as fluid was withdrawn were suggestive of malignancy or trapped lung. The measurement of pleural pressures in patients with pleural effusions may be useful diagnostically. More importantly, because large changes in pleural pressures are not readily detectable by the operator, pleural pressures should be monitored when large amounts (> 1,000 ml) of pleural fluid are removed to increase the safety of the procedure.