What is the role of bronchioalveolar lavage (BAL) in the diagnosis of eosinophilic granuloma (histiocytosis X)?

Updated: Mar 29, 2018
  • Author: Eleanor M Summerhill, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Analysis of bronchioalveolar lavage (BAL) fluid is sometimes diagnostic in pulmonary Langerhans cell histiocytosis X (PLCH). A greater than 5% increase in the number of Langerhans cells in BAL specimens is almost pathognomonic for PLCH. Although this finding is highly specific, it is not particularly sensitive. Langerhans cells can be recognized by their characteristic staining for S-100 protein or peanut agglutination antigen. These cells are CD1a-positive, and may also be identified by a specific monoclonal antibody (MT-1).


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