A patient with respiratory symptoms undergoes bronchoalveolar lavage. Which of the following findings would be MOST suggestive that congestive hea failure is the cause of the symptoms?
High-Yield Explanation
Hemosiderin-laden macrophages are sometimes called "hea failure cells" because they are so often seen in congestive hea failure. The congestive hea failure causes increased pulmonary capillary pressure with tiny hemorrhages. The pulmonary alveolar macrophages phagocytize the dead erythrocytes and retain the iron from the hemoglobin in the form of hemosiderin. Ciliated bronchial epithelial cells are a normal finding. The cocci described in choice B are pneumococcus, and can cause pneumonia. Rhomboid shaped crystals describes Charcot-Leyden crystals, found in allergic asthma.Ref: Essentials of Rubin's pathology, 5th Ed, Page 199.