Multinuclear giant cells in bronchoalveolar lavage in interstitial lung diseases

Our plain-English summary of Multinuclear giant cells in bronchoalveolar lavage in interstitial lung diseases, by C. Agustí, A. Xaubet, R. Arriols, et al (Respiration; International Review of Thoracic Diseases, 1987).

The study

• Authors: C. Agustí, A. Xaubet, R. Arriols, A. Marín, J.M. Montserrat, A. Agustí-Vidal
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1987;51(4):307-11
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The presence of multinuclear giant cells (MGC) is a pathological feature of interstitial lung diseases produced either by some organic and inorganic dust or by granulomatous disorders. In order to assess the diagnostic significance of the presence of MGC in bronchoalveolar lavage (BAL), the percent of MGC in the BAL of 52 subjects exposed to asbestos (26 with asbestosis) as well as from 79 with several interstitial lung diseases (idiopathic pulmonary fibrosis, pulmonary fibrosis associated with collagen vascular disorders, hypersensitivity pneumonitis and sarcoidosis) was compared with that of a control group of 14 subjects with no evidence of diffuse pulmonary disease. The results of this study suggest that MGC are present in the BAL of subjects with no pulmonary disease, and the quantification of these cells does not aid in the diagnostic evaluation of interstitial lung diseases.

In plain English

This study from a Barcelona hospital asked whether counting multinuclear giant cells (immune cells with several nuclei) in fluid washed out of the lungs (bronchoalveolar lavage) helps diagnose interstitial lung diseases. The authors analyzed 170 lavage samples from 145 people. These were 26 with asbestosis, 26 exposed to asbestos without evidence of lung disease, 79 with other interstitial lung diseases (hypersensitivity pneumonitis, idiopathic pulmonary fibrosis, fibrosis associated with collagen vascular disorders, and sarcoidosis), and 14 controls with no respiratory disease or exposure to toxic lung substances. Giant cells appeared in 96 of 170 samples (56%), including 9 of 14 from controls. On average, giant cells were 0.55% of alveolar macrophages in controls, 0.55% in the asbestos-exposed group and 0.48% in the asbestosis group. Only the sarcoidosis group had significantly lower counts than controls, a difference traced to stage I sarcoidosis. Smokers and nonsmokers did not differ significantly. The authors concluded these cells occur in people without respiratory disease and that counting them is not useful for diagnosing interstitial lung diseases. Fiber types and jobs of the asbestos-exposed participants were not described.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Comparison of lavage cell counts between patient groups and a control group (cross-sectional clinical study), compared using Student's t test
• Who was studied: 145 subjects (170 lavage samples) at the Hospital Clinic, University of Barcelona, Spain: 26 with asbestosis, 26 exposed to asbestos without evidence of lung disease, 12 with hypersensitivity pneumonitis, 18 with idiopathic pulmonary fibrosis, 20 with pulmonary fibrosis associated with collagen vascular disorders, 29 with sarcoidosis, and 14 controls. 55 were smokers. Study dates not given.
• Exposure: Asbestos exposure (with and without asbestosis). Fiber types, products, jobs and doses for these subjects were not described. Chrysotile is mentioned only in the discussion of a separate rat study.
• Main results:
  • Giant cells were found in 96 of 170 lavage samples (56%), making up 0.25 to 2.50% of alveolar macrophages. Giant cells were defined as alveolar macrophages with 4 or more nuclei, counted among 400 alveolar macrophages per lavage.
  • Controls: giant cells in 9 of 14 samples, mean 0.55% of alveolar macrophages (SD 0.74)
  • Asbestos-exposed subjects: giant cells in 16 of 26 samples, mean 0.55% of alveolar macrophages (SD 0.60). Asbestosis: giant cells in 18 of 26 samples, mean 0.48% (SD 0.64).
  • Only the sarcoidosis group had significantly lower giant-cell counts than controls (p = 0.01). This was accounted for by stage I sarcoidosis (p = 0.003).
  • The other groups, including the asbestos-exposed and asbestosis groups, did not differ significantly from controls
  • No significant difference between smokers (mean 0.48, SD 0.61) and nonsmokers (mean 0.35, SD 0.49)
• The authors' conclusion: The authors concluded that giant cells are present in lavage fluid of people with no evidence of respiratory disease, and that counting them is not useful in diagnosing interstitial lung diseases

Topics

Medical terms in this study, explained in our Lexicon: Bronchoalveolar Lavage (BAL), Interstitial Lung Disease, Idiopathic, Pulmonary Fibrosis, Collagen, Pneumonitis.

Related studies

• Brief inhalation of asbestos compromises superoxide production in cells from bronchoalveolar lavage — J.M. Petruska, J. Marsh, et al. (1990)
• Perls' Prussian Blue Stains of Lung Tissue, Bronchoalveolar Lavage, and Sputum — A.J. Ghio, V.L. Roggli (2021)
• Asbestos bodies in bronchoalveolar lavage fluids of brake lining and asbestos cement workers — P. Dumortier, P. De Vuyst, et al. (1990)
• Influence of cigarette smoking on bronchoalveolar lavage cellularity in asbestos-induced lung disease — D.A. Schwartz, J.R. Galvin, et al. (1992)
• Asbestos fibers in bronchoalveolar lavage and lung tissue of former asbestos workers — H. Teschler, K.H. Friedrichs, et al. (1994)
• Asbestos exposure assessment by mineralogical analysis of bronchoalveolar lavage fluid — P. Sartorelli, G. Scancarello, et al. (2001)

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