Am. J. Respir. Crit. Care Med.,
Volume 160, Number 2, August 1999, 730-731
Bronchoalveolar Lavage Fluid Granulomas in a
Case of Severe Sarcoidosis
MARK V.
HENDRICKS,
JOHN H.
CROSBY,
and
W. BRUCE
DAVIS
Section of Pulmonary Diseases, Department of Medicine, and Department of Pathology,
Medical College of Georgia, Augusta, Georgia
A case of pulmonary sarcoidosis is presented in which cytologic analysis of bronchoalveolar (BAL)
fluid showed intact granulomas. The patient had severe alveolar inflammation and probable endobronchial sarcoidosis. Thus the granulomas in the BAL fluid probably reflect a high burden of alveolar
wall granulomas and/or the removal of granulomas from proximal inflamed airways. This is the first
reported case of granulomas in BAL fluid in sarcoidosis. Although an unusual finding, the recovery of
BAL granulomas is not diagnostic for sarcoidosis and cannot substitute for the demonstration of
granulomatous inflammation in lung tissue.