To the Editor Dr von Bartheld and colleagues1 reported that among patients with suspected stage I/II pulmonary sarcoidosis undergoing tissue confirmation, the use of endosonographic nodal aspiration compared with bronchoscopic biopsy resulted in greater diagnostic yield.
Even though this was the focus of their study, they also reported bronchoalveolar lavage (BAL) results to assess its utility in diagnosing sarcoidosis. As also reported previously,2- 5 the value of a BAL in diagnosing sarcoidosis, as measured by CD4/CD8 ratio analysis with a cutoff value of 3.5, was limited.
Drent M, Baughman RP. Comparison of Methods to Diagnose Sarcoidosis. JAMA. 2013;310(15):1624–1625. doi:10.1001/jama.2013.277317