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Lipid-laden alveolar macrophage

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Pathological cells in lung
Lipid-laden alveolar macrophages in a case of vaping-associated pulmonary injury. Left: Papanicolaou stain; right: Oil Red O stain.

Lipid-laden alveolar macrophages, also known as pulmonary foam cells, are cells found in bronchoalveolar lavage (BAL) specimens that consist of macrophages containing deposits of lipids (fats). The lipid content of the macrophages can be demonstrated using a lipid targeting stain like Oil Red O or Nile red. Increased levels of lipid-laden alveolar macrophages are associated with various respiratory conditions, including chronic smoking, gastroesophageal reflux, lipoid pneumonia, fat embolism, pulmonary alveolar proteinosis and pulmonary aspiration. Lipid-laden alveolar macrophages have been reported in cases of vaping-associated pulmonary injury.

The lipid-laden macrophage index (LLMI) can be calculated by counting 100 macrophages in a BAL specimen treated with a lipid stain and scoring each macrophage from 0 to 4 based on the amount of lipids present in the cell. A LLMI score greater than 100 is considered positive for pulmonary aspiration. However, the test is limited by poor reproducibility and low specificity for pulmonary aspiration, as lipid-laden macrophages occur in many respiratory conditions.

See also

References

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  5. Fowler, S D; Greenspan, P (2017). "Application of Nile red, a fluorescent hydrophobic probe, for the detection of neutral lipid deposits in tissue sections: comparison with oil red O." Journal of Histochemistry & Cytochemistry. 33 (8): 833–836. doi:10.1177/33.8.4020099. ISSN 0022-1554. PMID 4020099.
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  9. ^ Lahiri, Thomas (2014). "The utility of the lipid-laden macrophage index for the evaluation of aspiration in children". Cancer Cytopathology. 122 (3): 161–162. doi:10.1002/cncy.21365. ISSN 1934-662X. PMID 24302605. S2CID 5283645.
  10. Maddock, Sean D.; Cirulis, Meghan M.; Callahan, Sean J.; Keenan, Lynn M.; Pirozzi, Cheryl S.; Raman, Sanjeev M.; Aberegg, Scott K. (2019). "Pulmonary Lipid-Laden Macrophages and Vaping". New England Journal of Medicine. 381 (15): 1488–1489. doi:10.1056/NEJMc1912038. ISSN 0028-4793. PMID 31491073. S2CID 201869784.
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