Bronchoalveolar lavage (BAL) specimens are usually split between cytology and microbiology. As different methodologies are used by these two laboratories in the work-up of these specimens, we thought it would be useful to review the results obtained on these specimens by each laboratory. Such a review might help define the relative sensitivities of the different procedures employed, suggest areas of redundancy that might be candidates for elimination, and help identify the procedures most likely to produce clinically significant results. Preliminary results suggest that cytology preparations are more sensitive for the direct detection of significant fungal pathogens than the smears prepared in microbiology. This is presumably because of the larger volume of material used for preparation of smears in cytology. The data for approximately 7 years have been collected and are currently being analyzed to assess the relative sensitivities of the procedures performed in the two laboratories for the detection of other pathogens such as Mycobacterium tuberculosis and Pneumocystis carinii.
