Liver Cirrhosis and Portal Hypertension
Q: What is the term for the accumulation of fluid in the peritoneal cavity, often associated with liver cirrhosis?
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Alveolar proteinosis in bronchoalveolar lavage (BAL) shows abundant, granular, eosinophilic proteinaceous material with scattered 'foamy' macrophages and cholesterol clefts. The background appears dirty with periodic acid-Schiff (PAS)-positive diastase-resistant material. Macrophages may contain PAS-positive granules. There is typically a paucity of inflammatory cells. This material represents surfactant accumulation due to impaired clearance. The cytological finding is characteristic but not pathognomonic; diagnosis is confirmed by clinical-radiological correlation and sometimes anti-GM-CSF antibodies. Therapeutic whole lung lavage may be performed based on these findings.
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