Procedimientos y terapéuticas
junto a numerosos macrófagos y células gigantes multinucleadas. En la silicosis, las partículas se detectan con luz polarizada con la que los cristales tienen un aspecto afilado, alargado y fragmentario. También se encuentran numerosos neutrófilos, macrófagos y células gigantes multinucleadas. En la bisinosis, la luz polarizada demuestra los cristales que tienen un aspecto rectangular, en forma de prisma y brillantes.
10. 11. 12.
4.4.4. Proteinosis alveolar
Se caracteriza por el depósito de material eosinofílico positivo al ácido peryódico-Schiff (PAS) en el interior de los alveolos y en los macrófagos sin alteración de la estructura pulmonar. Su diagnóstico se confirma por biopsia de pulmón, pero también puede realizarse en el esputo o la broncoscopia. BIBLIOGRAFÍA 1. Djukanovic R, Sterk PJ, Fahy JV, et al. Standardised methodology of sputum induction and processing. Eur Respir J Suppl 2002; 37:1s-2s. 2. Fahy JV, Wong H, Liu J, et al. Comparison of samples colected by sputum induction and bronchoscopy from asthmatic and healthy subjects. Am J Respir Crit Care Med 1995; 152:53-58. 3. Pizzichini E, Pizzichini MM, Efthimiadis A, et al. Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluid-phase measurements. Am J Respir Crit Care Med 1996; 154:308-317. 4. Spanevello A, Beghe B, Bianchi A, et al. Comparison of two methods of processing induced sputum: selected versus entire sputum. Am J Respir Crit Care Med 1998; 157:665-668. 5. Belda J, Parameswaran K, Hargreave FE. Comparison of two methods of processing induced sputum: selected versus entire sputum. Am J Respir Crit Care Med 1998; 158:680-682. 6. Geckler RW, Gremillion DH, McAllister CK, et al. Microscopic and bacteriological comparison of paired sputa and transtracheal aspirates. J Clin Microbiol 1977; 6:396-399. 7. Bartlett RC. A plea for clinical relevance in medical microbiology. Am J Clin Pathol 1974; 61:867-872. 8. Belda J, Leigh R, Parameswaran K, et al. Induced sputum cell counts in healthy adults. Am J Respir Crit Care Med 2000; 161:475-478. 9. Hunter CJ, Brightling CE, Woltmanw G, et al. A comparison of the validity of different diag-
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13. 14. 15.
16.
17. 18.
19. 20.
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24.
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