Bronchoalveolar lavage cytology in pulmonary sarcoidosis.

OBJECTIVE: To study the cytomorphologic findings in bronchoalveolar lavage (BAL) fluid in pulmonary sarcoidosis, relationship of the cytologic 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 findings consistent with pulmonary sarcoidosis. RESULTS: Clean background; 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 frequent finding was reactive nuclear changes in most multinucleate giant cells and epithelioid histiocytes, consisting of nuclear enlargement, open chromatin and one to two small, acidophilic nucleoli. CONCLUSION: The findings suggest that a BAL specimen in the majority of patients with pulmonary sarcoidosis yields this unique combination of cytologic features. The technique is accurate and economical and may be valuable in the management of such cases.