Difference between revisions of "Sarcoidosis"

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*Usu. minimal (lymphoid) inflammation; sarcoid granulomas are known as "naked granulomas".<ref name=pmid18948765>{{Cite journal  | last1 = Brinster | first1 = NK. | title = Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II). | journal = Adv Anat Pathol | volume = 15 | issue = 6 | pages = 350-69 | month = Nov | year = 2008 | doi = 10.1097/PAP.0b013e31818b1ac6 | PMID = 18948765 }}</ref>
*Usu. minimal (lymphoid) inflammation; sarcoid granulomas are known as "naked granulomas".<ref name=pmid18948765>{{Cite journal  | last1 = Brinster | first1 = NK. | title = Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II). | journal = Adv Anat Pathol | volume = 15 | issue = 6 | pages = 350-69 | month = Nov | year = 2008 | doi = 10.1097/PAP.0b013e31818b1ac6 | PMID = 18948765 }}</ref>
*In lung: interstitial location.
*In lung: interstitial location.
DDx:
*Reactive changes - may mimic sarcoidosis.
*Drug reaction.
**Anti-TNF therapy.<ref name=pmid22389903>{{Cite journal  | last1 = Tong | first1 = D. | last2 = Manolios | first2 = N. | last3 = Howe | first3 = G. | last4 = Spencer | first4 = D. | title = New onset sarcoid-like granulomatosis developing during anti-TNF therapy: an under-recognised complication. | journal = Intern Med J | volume = 42 | issue = 1 | pages = 89-94 | month = Jan | year = 2012 | doi =  | PMID = 22389903 }}</ref>
**Ipilimumab.<ref name=pmid24124863>{{Cite journal  | last1 = Reule | first1 = RB. | last2 = North | first2 = JP. | title = Cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab. | journal = J Am Acad Dermatol | volume = 69 | issue = 5 | pages = e272-3 | month = Nov | year = 2013 | doi = 10.1016/j.jaad.2013.07.028 | PMID = 24124863 }}</ref>


===Images===
===Images===

Revision as of 21:24, 25 November 2013

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.
  • 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.

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.