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Cytology of treated and minimal Pneumocystis carinii pneumonia and a pitfall of the Grocott methenamine silver stain.
Diagn Cytopathol. 1991; 7(1):41-7.DC

Abstract

To clarify the role of foamy alveolar casts (FACs) in the diagnosis of Pneumocystis carinii pneumonia (PCP), we retrospectively reviewed Papanicolaou (Pap)- and Grocott methenamine silver (GMS)-stained slides from 205 bronchial specimens submitted for suspected opportunistic lung infection. FACs containing sporozoites were seen in 86 cases, all with positive GMS. FACs were absent in 119 cases with negative GMS. In patients previously treated for PCP, Pap showed FAC-like material which lacked sporozoites. GMS demonstrated clumped degenerated Pneumocystis carinii (PC) cysts. In 17 GMS-positive cases there were no FACs on Pap due to sampling error and low burden of organisms. Morphologic features of macrophages in these cases can suggest the presence of PC. When FACs are lacking, a special stain is required. When GMS is used, the control must contain PC to avoid a false negative GMS. The inconsistent uptake of GMS by PC is a pitfall which is distinct from sampling error and which to our knowledge has not been previously reported.

Authors+Show Affiliations

Department of Pathology, Hahnemann University Medical College and Hospital, Philadelphia, PA 19102-1192.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1709086

Citation

Naryshkin, S, et al. "Cytology of Treated and Minimal Pneumocystis Carinii Pneumonia and a Pitfall of the Grocott Methenamine Silver Stain." Diagnostic Cytopathology, vol. 7, no. 1, 1991, pp. 41-7.
Naryshkin S, Daniels J, Freno E, et al. Cytology of treated and minimal Pneumocystis carinii pneumonia and a pitfall of the Grocott methenamine silver stain. Diagn Cytopathol. 1991;7(1):41-7.
Naryshkin, S., Daniels, J., Freno, E., & Cunningham, L. (1991). Cytology of treated and minimal Pneumocystis carinii pneumonia and a pitfall of the Grocott methenamine silver stain. Diagnostic Cytopathology, 7(1), 41-7.
Naryshkin S, et al. Cytology of Treated and Minimal Pneumocystis Carinii Pneumonia and a Pitfall of the Grocott Methenamine Silver Stain. Diagn Cytopathol. 1991;7(1):41-7. PubMed PMID: 1709086.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytology of treated and minimal Pneumocystis carinii pneumonia and a pitfall of the Grocott methenamine silver stain. AU - Naryshkin,S, AU - Daniels,J, AU - Freno,E, AU - Cunningham,L, PY - 1991/1/1/pubmed PY - 1991/1/1/medline PY - 1991/1/1/entrez SP - 41 EP - 7 JF - Diagnostic cytopathology JO - Diagn Cytopathol VL - 7 IS - 1 N2 - To clarify the role of foamy alveolar casts (FACs) in the diagnosis of Pneumocystis carinii pneumonia (PCP), we retrospectively reviewed Papanicolaou (Pap)- and Grocott methenamine silver (GMS)-stained slides from 205 bronchial specimens submitted for suspected opportunistic lung infection. FACs containing sporozoites were seen in 86 cases, all with positive GMS. FACs were absent in 119 cases with negative GMS. In patients previously treated for PCP, Pap showed FAC-like material which lacked sporozoites. GMS demonstrated clumped degenerated Pneumocystis carinii (PC) cysts. In 17 GMS-positive cases there were no FACs on Pap due to sampling error and low burden of organisms. Morphologic features of macrophages in these cases can suggest the presence of PC. When FACs are lacking, a special stain is required. When GMS is used, the control must contain PC to avoid a false negative GMS. The inconsistent uptake of GMS by PC is a pitfall which is distinct from sampling error and which to our knowledge has not been previously reported. SN - 8755-1039 UR - https://www.unboundmedicine.com/medline/citation/1709086/Cytology_of_treated_and_minimal_Pneumocystis_carinii_pneumonia_and_a_pitfall_of_the_Grocott_methenamine_silver_stain_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=8755-1039&date=1991&volume=7&issue=1&spage=41 DB - PRIME DP - Unbound Medicine ER -