Bronchoalveolar lavage (BAL) was performed in 48 subjects: 22 healthy controls, 13 patients with pulmonary sarcoidosis Stage I and 13 patients with lung cancer. All diagnoses were pathologically and clinically confirmed. Cytocentrifuge preparations were made, air-dried and stained for cytochemical examination of alveolar macrophages (AM) using indexing and scoring methods for the evaluation of esterase activity, intracellular amounts of glycogen, lipids and iron. Significant differences were found in the cytochemical examination of enzyme activity of AM and intracellular metabolic and ionic state, depending on pathological processes and smoking habits. There was a linear correlation between alpha naphthyl esterase activity and iron content in AM in patients with squamous cell lung carcinoma and in patients with pulmonary sarcoidosis, which makes it possible to assign individual patients to one of the groups. Cytochemical examination of BAL specimens might be of great significance for the prevention and early diagnosis of various malignant and non-malignant lung diseases.
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