Sarcoidosis

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Sarcoidosis is non-necrotizing granulomatous disease of unknown etiology. It classically associated with (pulmonary) hilar lymphadenopathy. It may be found in almost any organ, e.g. heart, appendix.

General

  • Diagnosis of exclusion - infection must be excluded.
  • Rare.

Gross

  • Bilateral lymphadenopathy ~90% of cases.

Note:

  • Radiologic differential diagnosis includes carcinomatosis.[1]

Microscopic

Features:

  • Granulomata, well-formed, non-necrotizing.
    • Negative for microorganisms with special stains (PAS-D, GMS, AFB).
  • Usu. minimal (lymphoid) inflammation; sarcoid granulomas are known as "naked granulomas".[2]
  • In lung: interstitial location.

DDx:

  • Reactive changes - may mimic sarcoidosis.
  • Drug reaction.
    • Anti-TNF therapy.[3]
    • Ipilimumab.[4]

Images

www:

Stains

  • ZN -ve.
  • PASD -ve.
  • GMS -ve.

Note:

  • Done to r/o infection.

Sign out

  • Should be something like sarcoid-like granulomas and clinical correlation required.

See also

References

  1. URL: http://www.radiologyassistant.nl/en/46b480a6e4bdc. Accessed on: 23 May 2010.
  2. Brinster, NK. (Nov 2008). "Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II).". Adv Anat Pathol 15 (6): 350-69. doi:10.1097/PAP.0b013e31818b1ac6. PMID 18948765.
  3. Tong, D.; Manolios, N.; Howe, G.; Spencer, D. (Jan 2012). "New onset sarcoid-like granulomatosis developing during anti-TNF therapy: an under-recognised complication.". Intern Med J 42 (1): 89-94. PMID 22389903.
  4. Reule, RB.; North, JP. (Nov 2013). "Cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab.". J Am Acad Dermatol 69 (5): e272-3. doi:10.1016/j.jaad.2013.07.028. PMID 24124863.