A case series on reactive atypia findings in cytology examination of bronchoalveolar lavage samples

Abstract

ABSTRACT Reactive atypia in bronchoalveolar lavage (BAL) cells reflects cellular changes frequently observed in respiratory cytology, typically resulting from injury, inflammation, or irritation rather than malignancy. This review examines the nature, causes, and diagnostic implications of reactive atypia in BAL specimens. BAL is a diagnostic procedure used to collect cells from the lower respiratory tract. Identifying atypical cells in BAL samples poses a significant challenge, as their morphology can resemble that of neoplastic processes. Characteristics of reactive atypia include nuclear enlargement, hyperchromasia, irregular nuclear contours, and increased nucleocytoplasmic ratios. These changes are often attributable to inflammation, infections, toxic exposures (such as smoking), and chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease. This case series discusses three instances of reactive atypia encountered in BAL sample analysis. Reactive atypia in BAL cells is a common, benign response to various stimuli. Accurate diagnosis necessitates a comprehensive approach that integrates cytological findings, clinical context, and adjunctive diagnostic tools. Ongoing research into the molecular characteristics of reactive atypia has the potential to enhance diagnostic precision and improve patient care.