WHAT CONSTITUTES AN ADEQUATE SPUTUM SPECIMEN - COMPARISON OF POLYMORPHONUCLEAR LEUKOCYTES AND ALVEOLAR MACROPHAGES

We studied the correlation between microbiologic and cytologic specime n adequacy and compared the presence of polymorphonuclear cells with t hat of alveolar macrophages. We stained 60 expectorated specimens cons ecutively submitted for cytological examination with Papanicolaou's an d Gram's stains. Classically, the cytological criteria for an unsatisf actory expectorated specimen is less that S alveolar macrophages per s lide. The presence of polymorphonuclear cells seen on Gram's stain did not correlate with alveolar macrophages seen on Papanicolaou stain fr om the same specimen. Of 3 specimens with more than 9 polymorphonuclea r cells per X 100 microscopic field on Gram's stain, only 14 (47%) bad 5 or more 71022 167 alveolar macrophages per slide on Papanicolaou's stain. Of 30 specimens with less than 10 polymorphonuclear cells per X 100 field, 19 (63%) had S or more alveolar macrophages per slide. Whe n results Of cytologically Unsatisfactory expectorated specimens were compared with bronchoscopy specimens on the same patient, the number a nd quantity of inflammatory cells other than alveolar macrophages agre ed in 94% of the cases. These data suggest that useful information is available on expectorated specimens judged cytologically unsatisfactor y.