Korean J Pathol.  2002 Jun;36(3):175-178.

Bronchoalveolar Lavage (BAL) Cytology and Ultrastructural Findings in a Patient with Amiodarone-Induced Pulmonary Toxicity: A Case Report

• Lee S
• Kim MA
• Shim YS
• Lee CT
• Chi JG
• Chung DH

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.

Keyword

Amiodarone; Bronchoalveolar Lavage; Lung; Microscopy, Electron

MeSH Terms

Amiodarone
Biopsy
Bronchoalveolar Lavage*
Cough
Cytoplasm
Diagnosis
Dyspnea
Foam Cells
Humans
Lung
Microscopy, Electron
Pulmonary Fibrosis
Thorax
Vacuoles
Amiodarone