Tags

Type your tag names separated by a space and hit enter

Utility of reflex Gomori methenamine silver staining for Pneumocystis jirovecii on bronchoalveolar lavage cytologic specimens: a review.
Diagn Cytopathol. 2006 Nov; 34(11):719-23.DC

Abstract

Pneumocystis jiroveci (Pj; formerly Pneumocystis carinii) is an opportunistic pathogen causing life-threatening pneumonia (Pneumocystis pneumonia) in immunosuppressed individuals. Its diagnosis is dependent on identification in bronchoalveolar lavage (BAL) specimens. Gomori's methenamine silver nitrate (GMS) stain has been advocated to highlight the organisms in BAL specimens. This study was performed to determine the utility of reflex GMS staining on all BAL specimens for identifying Pj.All BAL specimens from years 2000 to 2004 were processed as cytospins and stained with Papanicolaou (Pap) and GMS stains. A total of 2,984 BAL specimens were identified. A total of 116 (3.9% of total BAL) BAL specimens were diagnostic of Pj. The diagnostic specimens were grouped as follows: 103 (88.8% of total positive cases) Pj identified with both Pap and GMS staining; 11 (9.5% of total positive cases) Pj identified only with Pap staining; and 2 (1.7% of total positive cases) Pj identified only with GMS staining. In conclusion, the prevalence of Pj in BAL specimens is 3.9%, which can be attributed to improved management of immunocompromised patients. Performing reflex GMS staining on all BAL specimens does not improve the diagnostic identification of Pj since the majority (98.3%) of diagnoses can be rendered on Pap stained slides. A cost analysis for GMS staining on 2,879 GMS-negative BAL specimens was estimated at $143,950. Thus, from diagnostic and cost benefit perspectives, GMS staining can be recommended only on cases where Pap stain is negative, and the clinical presentation is consistent with Pneumocystis pneumonia.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, School of Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA 30322, USA. anassar@emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17041954

Citation

Nassar, Aziza, et al. "Utility of Reflex Gomori Methenamine Silver Staining for Pneumocystis Jirovecii On Bronchoalveolar Lavage Cytologic Specimens: a Review." Diagnostic Cytopathology, vol. 34, no. 11, 2006, pp. 719-23.
Nassar A, Zapata M, Little JV, et al. Utility of reflex Gomori methenamine silver staining for Pneumocystis jirovecii on bronchoalveolar lavage cytologic specimens: a review. Diagn Cytopathol. 2006;34(11):719-23.
Nassar, A., Zapata, M., Little, J. V., & Siddiqui, M. T. (2006). Utility of reflex Gomori methenamine silver staining for Pneumocystis jirovecii on bronchoalveolar lavage cytologic specimens: a review. Diagnostic Cytopathology, 34(11), 719-23.
Nassar A, et al. Utility of Reflex Gomori Methenamine Silver Staining for Pneumocystis Jirovecii On Bronchoalveolar Lavage Cytologic Specimens: a Review. Diagn Cytopathol. 2006;34(11):719-23. PubMed PMID: 17041954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of reflex Gomori methenamine silver staining for Pneumocystis jirovecii on bronchoalveolar lavage cytologic specimens: a review. AU - Nassar,Aziza, AU - Zapata,Mauricio, AU - Little,James V, AU - Siddiqui,Momin T, PY - 2006/10/17/pubmed PY - 2007/1/5/medline PY - 2006/10/17/entrez SP - 719 EP - 23 JF - Diagnostic cytopathology JO - Diagn Cytopathol VL - 34 IS - 11 N2 - Pneumocystis jiroveci (Pj; formerly Pneumocystis carinii) is an opportunistic pathogen causing life-threatening pneumonia (Pneumocystis pneumonia) in immunosuppressed individuals. Its diagnosis is dependent on identification in bronchoalveolar lavage (BAL) specimens. Gomori's methenamine silver nitrate (GMS) stain has been advocated to highlight the organisms in BAL specimens. This study was performed to determine the utility of reflex GMS staining on all BAL specimens for identifying Pj.All BAL specimens from years 2000 to 2004 were processed as cytospins and stained with Papanicolaou (Pap) and GMS stains. A total of 2,984 BAL specimens were identified. A total of 116 (3.9% of total BAL) BAL specimens were diagnostic of Pj. The diagnostic specimens were grouped as follows: 103 (88.8% of total positive cases) Pj identified with both Pap and GMS staining; 11 (9.5% of total positive cases) Pj identified only with Pap staining; and 2 (1.7% of total positive cases) Pj identified only with GMS staining. In conclusion, the prevalence of Pj in BAL specimens is 3.9%, which can be attributed to improved management of immunocompromised patients. Performing reflex GMS staining on all BAL specimens does not improve the diagnostic identification of Pj since the majority (98.3%) of diagnoses can be rendered on Pap stained slides. A cost analysis for GMS staining on 2,879 GMS-negative BAL specimens was estimated at $143,950. Thus, from diagnostic and cost benefit perspectives, GMS staining can be recommended only on cases where Pap stain is negative, and the clinical presentation is consistent with Pneumocystis pneumonia. SN - 8755-1039 UR - https://www.unboundmedicine.com/medline/citation/17041954/Utility_of_reflex_Gomori_methenamine_silver_staining_for_Pneumocystis_jirovecii_on_bronchoalveolar_lavage_cytologic_specimens:_a_review_ L2 - https://doi.org/10.1002/dc.20540 DB - PRIME DP - Unbound Medicine ER -