BRONCHOALVEOLAR LAVAGE FLUID PROFILES IN SARCOIDOSIS, TUBERCULOSIS, AND NON-HODGKINS AND HODGKINS-DISEASE

aim of this study was to identify characteristic features in bronchoal veolar lavage fluid (BALF) samples of patients with tuberculosis, non- Hodgin's or Hodgkin's disease and to investigate whether these differe nces facilitate the distinction of those disorders from sarcoidosis pr esenting with a similar clinical picture. Nonsmoker patients with hist ologically verified sarcoidosis (n = 29), tuberculosis (n = 6) proven by positive culture, non-Hodgkin's disease, (n = 6) or Hodgkin's disea se (n = 7), both histologically verified, were investigated by BAL. A control group consisted of subjects without any pulmonary history. The presence of CD4(+) and CD8(+) T lymphocytes, as well as the CD4/CD8 r atio in BALF, aided in the differentiation between the various groups. Patients with malignant lymphomas had the lowest CD4/CD8 ratio in BAL F, as well as in peripheral blood, and occasionally, plasma cells were present in BALF samples. The most important feature of BALF analysis in tuberculosis was detection of the causal microbial agent. In conclu sion, although malignant lymphomas and tuberculosis require histologic evaluation and a positive culture, respectively, for diagnosis, BALF analysis may be of additional value in distinguishing those disorders from sarcoidosis.