Bronchoalveolar lavage and transbronchial lung biopsy in sarcoidosis and extrinsic allergic alveolitis.

Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) in the same endoscopic session were performed in 44 patients: 20 were affected by active sarcoidosis (AS), 15 by inactive sarcoidosis (IS) and nine by extrinsic allergic alveolitis (EAA). Compared with 12 healthy controls, in EAA and AS patients the total number of cells and the percentage of lymphocytes were increased both in smokers and non-smokers. TBLB showed sarcoid granulomata in 15 AS and six IS patients, interstitial fibrosis in four AS and seven IS patients, and normal lung tissue in two IS patients. In EAA, TBLB revealed granulomata or mononuclear infiltrates in four patients and fibrosis in a further four. Regarding the correlation between TBLB and BAL, sarcoid granulomata were more frequently found in patients with AS, as reflected by the increased number of lymphocytes in BAL. The procedure produced no significant complications.