BRONCHOALVEOLAR LAVAGE CYTOLOGY IN PULMONARY SARCOIDOSIS

OBJECTIVE: To study the cytomorphologic findings in bronchoalveolar la vage (BAL) fluid in pulmonary sarcoidosis, relationship of the cytolog ic findings to radiologic stage and cytohistomorphologic correlation. STUDY DESIGN: We retrospectively studied the cytologic findings in BAL specimens from 26 patients who had clinical features and histologic f indings consistent with pulmonary sarcoidosis. RESULTS: Clean backgrou nd; scattered, multinucleate giant cells; epithelioid cells; reactive alveolar macrophages; and a significant population of lymphocytes were observed in 88.5% (23/26) of cases of pulmonary sarcoidosis. A freque nt finding was reactive nuclear changes in most multinucleate giant ce lls and epithelioid histiocytes, consisting of nuclear enlargement, op en chromatin and one to two small, acidophilic nucleoli. CONCLUSION: T he findings suggest that a BAL specimen in the majority of patients wi th pulmonary sarcoidosis yields this unique combination of cytologic f eatures. The technique is accurate and economical and may be valuable in the management of such cases.