Diagnostic value of hemosiderin-containing macrophages in bronchoalveolar lavage

Chest. 1992 Dec;102(6):1794-9. doi: 10.1378/chest.102.6.1794.


Study objective: Our objective was to determine if the hemosiderin content of BAL macrophages allows us to draw any differential diagnostic conclusions in a variety of lung diseases.

Patients and study design: One hundred one patients who underwent BAL for different diagnostic reasons were studied prospectively.

Main results: The highest values for the hemosiderin score (HS) were found in patients with active alveolar hemorrhage and patients who had undergone heart transplantation for congestive heart failure. Compared to a control population, patients with Pneumocystis carinii pneumonia or invasive aspergillosis had a higher HS than patients with bacterial pneumonia or mycobacterial lung infection. High or intermediate values for HS were more often found in patients with a low than in those with a normal platelet count.

Conclusions: The differential diagnostic conclusions which can be based on an HS are limited.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchoalveolar Lavage Fluid / microbiology
  • Bronchoalveolar Lavage Fluid / pathology*
  • Bronchoscopy
  • Erythrocytes / pathology
  • Female
  • Heart Transplantation / pathology
  • Hemorrhage / pathology
  • Hemosiderin / analysis*
  • Humans
  • Immunocompromised Host
  • Lung Diseases / pathology
  • Macrophages, Alveolar / chemistry*
  • Macrophages, Alveolar / pathology
  • Male
  • Middle Aged
  • Pneumonia / pathology
  • Pulmonary Alveoli / pathology
  • Smoking / pathology


  • Hemosiderin