Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Ratio, Bronchoalveolar Lavage
Ordering Recommendation

Support the diagnosis of sarcoidosis.

Flow Cytometry
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Time SensitiveTime Sensitive
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Bronchoalveolar lavage (Bronch Wash or BAL).  
Specimen Preparation
Transfer 4 mL bronchoalveolar lavage to a sterile container. (Min: 3 mL)  
Storage/Transport Temperature
Unacceptable Conditions
Whole blood (refer to ARUP test code 0095950). Excess mucus, excess peripheral blood, or too few lymphocytes.  Frozen or room temperature specimens. Specimens older than 48 hours. Contaminated specimens.  
Specimens must be analyzed within 48 hours of collection.  
Ambient: Unacceptable, Refrigerated: 48 hours, Frozen: Unacceptable  
Reference Interval
By report
Interpretive Data
A CD4/CD8 ratio greater than 3.5 is suggestive of sarcoidosis. If the CD4/CD8 ratio is greater than 5.0 and clinical and radiographic findings are compatible with sarcoidosis, some institutions accept a diagnosis of sarcoidosis even with a negative biopsy. In extrinsic allergic alveolitis (EAA), the CD4/CD8 ratio is decreased due to a relative increase in the CD8 positive T-cells.

The performance characteristics of this test were determined by ARUP Laboratories, Inc.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.
This test is designed for enumerating the percent of T-Cell lymphocyte subsets in BAL. Cells from the BAL are added to fluorochrome-labeled antibodies that bind specifically to cell surface antigens on lymphocytes. The CD4/CD8 ratio is calculated by dividing the CD4 percent by the CD8 percent.
CPT Code(s)
86356 x3
Component Test Code*Component Chart NameLOINC
0093421% CD3 - BAL
0093422% CD4 - BAL
0093423% CD8 - BAL
0093424CD4:CD8 Ratio - BAL
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • BAL for CD4/CD8 Ratio
  • Bronch Wash for CD4:CD8 Ratio