SPECIFICITY OF BRONCHOALVEOLAR LAVAGE FOR THE DIAGNOSIS OF FAT-EMBOLISM SYNDROME

The diagnosis of fat embolism syndrome (FES) is relatively difficult b ecause simple, quantitative criteria have been lacking. The results of a recent study, however, suggest that the diagnosis of FES can be mad e if more than 5 per cent of the cells in fluid obtained by bronchoalv eolar lavage are lipid-laden. Our study was designed to assess the spe cificity of this lipid staining test of bronchoalveolar cells for diag nosing FES in a series of patients coming to the pulmonology clinic. T hirty-four consecutive patients with suspected pulmonary diseases, but not FES, underwent routine bronchoscopy. Bronchoalveolar fluid was ap plied to slides, fixed with formalin, and stained with oil red 0. Thre e hundred consecutive cells of each specimen were observed for red-sta ining droplets. More than 5 per cent of bronchoalveolar lavage cells s tained for lipids in 25 of the 34 subjects. The calculated specificity , assuming a negative finding is defined as less-than-or-equal-to 5 pe r cent lipid-laden cells in the sample, was 26.5 per cent. We conclude that staining of bronchoalveolar lavage cells for lipids is not a spe cific test for FES.