Cytological Characteristics and Clinical Significance of Ciliocytophthoria in Bronchoalveolar Lavages Specimens.

Abstract

Objectives: Ciliocytophthoria (CCP) is traditionally described as a cytopathic degeneration pattern, yet its clinical and analytic relevance remains poorly defined. This study evaluated the clinicopathologic, microbiologic, and cytologic features of CCP in bronchoalveolar lavage (BAL) specimens.

Methods: Fourteen BAL specimens with CCP were retrospectively analyzed. Clinical, demographic, imaging, microbiologic, and laboratory data were reviewed. Cytologic evaluation included background degeneration, inflammation, and CCP counts. Processing times were recorded, and correlations between preanalytic variables and CCP density were assessed.

Results: The cohort included 7 men and 7 women (age range 29-73 years, mean 54.9). Dyspnea (57.1%), cough (50%), and fever (50%) were the most common presenting symptoms. Ground-glass opacities were the predominant imaging finding (71.4%). Acute-phase reactants were elevated in 90.9%, and immunologic markers positive in 88.9% of tested patients. Bacterial cultures were positive in 42.9%. Fungal cultures were positive in 21.4% of cases, although all fungal isolates were Candida albicans. Viral positivity occurred in 36.4%, including two with SARS-CoV-2 infection. Cytologic review showed variable degeneration and inflammation, with no viral inclusions. CCP counts ranged from 3 to >50 with no correlation seen between CCP counts and sample processing time (p=0.068) or background degeneration (p=0.802).

Conclusions: This study highlights CCP as an under-recognized but reproducible cytomorphologic feature in bronchoalveolar specimens. The findings reinforce its interpretation as a nonspecific marker of epithelial injury and airway insult rather than a pathogen-specific change, and extend its clinical associations to include bacterial contexts in addition to previously described viral settings.