Time Sensitive

Ordering Recommendation

Use to support a diagnosis of sarcoidosis.

New York DOH Approval Status

This test is New York state approved.

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.

Separate orders must be submitted for multiple samples from different source sites. The collection time may need to vary in submitting samples with the same collection date. An except will be created if multiple samples are submitted under one order only.


Ambient: Unacceptable; Refrigerated: 48 hours; Frozen: Unacceptable


Flow Cytometry




1-3 days

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.

Compliance Category

Laboratory Developed Test (LDT)


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.

Hotline History


CPT Codes

86356 x3


Component Test Code* Component Chart Name LOINC
0093421 % CD3 - BAL 97594-6
0093422 % CD4 - BAL 97595-3
0093423 % CD8 - BAL 97596-1
0093424 CD4:CD8 Ratio - BAL 97599-5
0095737 Source: 31208-2
* 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
Lymphocyte Subset Panel 4 - T-Cell Subsets Percent and Ratio, Bronchoalveolar Lavage