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We studied lung and blood lymphocytes from 12 asymptomatic patients with peripheral bronchogenic carcinoma. Bronchoalveolar lavage was performed in the lung segment with tumor and a contralateral uninvolved lung segment and analyzed separately. After partial removal of macrophages by plastic adherence, cells were labeled with markers for CD4 and CD8 and analyzed by flow cytometric analysis. We found no significant difference in the percentages of mononuclear cells in either immune subset when comparing the lung containing tumor with the uninvolved lung. We did find, however, a depressed CD4/CD8 ratio in the peripheral blood. We conclude that a lung carcinoma does not change the local immunologic milieu of the lung parenchyma containing the carcinoma. It is not clear if the immunologic findings in the lungs and blood are due to the bronchogenic carcinoma, smoking, or the underlying chronic obstructive pulmonary disease.

Five patients with suspected metastatic bronchogenic carcinoma underwent needle aspiration of peripheral metastatic lesions instead of a diagnostic bronchoscopy. Aspirates were from the soft tissue of the proximal arm (three patients), an axillary mass (one patient), and a skin nodule (one patient). Two patients had non-small cell carcinoma, two had small cell carcinoma, and one patient had a nondiagnostic aspirate. The procedure had insignificant morbidity, was easy to perform, quickly established a diagnosis of metastatic disease, and obviated the need for a more invasive diagnostic procedure in four of the five patients.