Bronchoalveolar lavage macrophage-lymphocyte clusters in granulomatous disease are linked to lymphocytosis.

BACKGROUND AND AIM OF THE WORK: Clusters of macrophages associated with lymphocytes (ML clusters) have been observed among the bronchoalveolar lavage (BAL) cells of patients with pulmonary disease. We tested the hypothesis that ML clusters might be found among the BAL cells from patients with granulomatous disease.

METHODS

We measured the number of ML clusters among the BAL cells from normal controls (n = 13), sarcoidosis patients (n = 18), beryllium-sensitized (BeS) patients (n = 21) and chronic beryllium disease (CBD) patients (n = 15).

RESULTS

ML clusters were observed in the BAL cells of all groups, but at different frequencies: normal 8.5% (median, range 2-15%); BeS 7% (range 2-31%); sarcoidosis 14% (range 4-50%); and CBD 17% (range 6-73%). This data suggested that ML clusters were increased in granulomatous lung disease. However, the percentage of ML clusters strongly correlated with the BAL lymphocyte percentage (rho = 0.79). Cohort analysis showed that increases in macrophages having 2, 3 or > 3 associated lymphocytes correlated with an increase in lymphocyte percentage.

CONCLUSIONS

An increase in ML clusters in BAL cells is not specific for granulomatous disease and is associated with the increase in BAL lymphocytes.