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The Korean Journal of Pathology 2002;36(3): 175-178.
Bronchoalveolar Lavage (BAL) Cytology and Ultrastructural Findings in a Patient with Amiodarone-Induced Pulmonary Toxicity: A Case Report.
Sun Lee, Min A Kim, Young Soo Shim, Chun Taek Lee, Je G Chi, Doo Hyun Chung
1Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. doohyun@plaza.snu.ac.kr
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.
Key Words: Amiodarone; Bronchoalveolar Lavage; Lung; Microscopy, Electron
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