A 44-year-old woman comes to the physician because of a 6-month history of fatigue, intermittent fever, a 4.0-kg (9-lb) weight loss, and a progressive, nonproductive cough. She does not smoke. Physical examination shows mild wheezing over bilateral lung fields. Chest x-ray demonstrates enlarged hilar lymph nodes, and laboratory testing reveals an elevated ACE level. Purified protein derivative testing is negative. A bronchoscopy is scheduled to help determine the diagnosis. Which of the following is most likely to be the predominant cell type in this patient's bronchoalveolar lavage fluid?

Question

A 44-year-old woman comes to the physician because of a 6-month history of fatigue, intermittent fever, a 4.0-kg (9-lb) weight loss, and a progressive, nonproductive cough. She does not smoke. Physical examination shows mild wheezing over bilateral lung fields. Chest x-ray demonstrates enlarged hilar lymph nodes, and laboratory testing reveals an elevated ACE level.  Purified protein derivative testing is negative.  A bronchoscopy is scheduled to help determine the diagnosis.  Which of the following is most likely to be the predominant cell type in this patient's bronchoalveolar lavage fluid?

Quizplus · Accepted Answer

Eductional Objective: Sarcoidosis is a CD4⁺ T-cell mediated disease, in which large numbers of CD4⁺ lymphocytes release interferon-gamma and tumor necrosis factor-alpha to drive macrophage activation and granuloma formation. Bronchoalveolar lavage fluid in pulmonary sarcoidosis demonstrates a lymphocytic predominance with a high CD4⁺/CD8⁺ ratio.

A 44-Year-Old Woman Comes to the Physician Because of a 6-Month