Pathology of Sarcoidosis

Rosen, Yale

doi:10.1055/s-2007-970332

Cited by 167 publications

(106 citation statements)

References 85 publications

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“…A biopsy specimen confirms the diagnosis of sarcoidosis by revealing non caseating epithelioid cell granulomas and by excluding other known causes of granulomatous inflammation like fungal, mycobacterial, and parasitic infections, and vacuities such as Wegener's granulomatosis. 14 Additionally hepatosplenic sarcoidosis most commonly manifests as organomegaly, as in our patient. Of patients with systemic sarcoidosis, 24% to 94% have biopsy-documented hepatic sarcoidosis.…”

Section: Figure 4 Lung Biopsy Showing Granulomatous Inflammation Witsupporting

confidence: 60%

Pediatric-onset adult type sarcoidosis: A case report

2015

Arch Argent Pediat

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Sarcoidosis, a multisystem disorder of unknown etiology that involves multiple organs, is rare in children. The true incidence and prevalence of childhood sarcoidosis is unknown. As in adults, many children with sarcoidosis may be asymptomatic; the disease may remain undiagnosed. A complete and systematic evaluation of the patient is essential for the sarcoidosis diagnosis in children. Here, we describe a case of 12-year-old female who presented with 2 years history of uveitis and hepatosplenomegaly. A chest computerized tomography revealed scattered peripheral pulmonary nodules and bilateral hiliar lymphadenopathy. Bone marrow aspiration and liver biopsy were not diagnostic. A lung biopsy showed non-necrotizing epithelioid cell granulomas. She was diagnosed with sarcoidosis according to demonstration of granulomatous inflammation and the exclusion of confusable entities.

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Section: Figure 4 Lung Biopsy Showing Granulomatous Inflammation Witsupporting

confidence: 60%

Pediatric-onset adult type sarcoidosis: A case report

2015

Arch Argent Pediat

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“…Sarcoidosis is a systemic granulomatous disease1, 2 with a predilection towards the cardiovascular system 2. Most patients with sarcoidosis either remain clinically silent or present with nonspecific constitutional symptoms 3.…”

Section: Introductionmentioning

confidence: 99%

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Patel

Kalra

Doshi

et al. 2018

JAHA

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BackgroundRecent trends of hospitalizations and in‐hospital mortality are not well defined in sarcoidosis. We examined aforementioned trends and prevalence of cardiovascular manifestations and explored rates of implantable cardioverter‐defibrillator implantation in hospitalizations with sarcoidosis.Methods and ResultsUsing data from the National Inpatient Sample, a retrospective population cohort from 2005 to 2014 was studied. To identify sarcoidosis, an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis code was used. We excluded hospitalizations with myocardial infarction, coronary artery disease, and ischemic cardiomyopathy. Cardiovascular manifestations were defined by the presence of diagnosis codes for conduction disorders, arrhythmias, heart failure, nonischemic cardiomyopathy, and pulmonary hypertension. A total of 609 051 sarcoidosis hospitalizations were identified, with an age of 55±14 years, 67% women, and 50% black. The number of sarcoidosis hospitalizations increased from 2005 through 2014 (138 versus 175 per 100 000, P trend<0.001). We observed declining trends of unadjusted in‐hospital mortality (6.5 to 4.9 per 100 sarcoidosis hospitalizations, P trend<0.001). Overall ≈31% (n=188 438) of sarcoidosis hospitalizations had coexistent cardiovascular manifestations of one or more type. Heart failure (≈16%) and arrhythmias (≈15%) were the most prevalent cardiovascular manifestations. Rates of implantable cardioverter‐defibrillator placement were ≈7.5 per 1000 sarcoidosis hospitalizations (P trend=0.95) during the study period. Black race was associated with 21% increased risk of in‐hospital mortality (odds ratio, 1.21; 95% confidence interval, 1.16–1.27 [P<0.001]).ConclusionsSarcoidosis hospitalizations have increased over the past decade with a myriad of coexistent cardiovascular manifestations. Black race is a significant predictor of in‐hospital mortality, which is declining. Further efforts are needed to improve care in view of low implantable cardioverter‐defibrillator rates in sarcoidosis.

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“…The question whether NSG is a vasculitis with sarcoid reaction (angiocentric granulomatosis) or a variant of sarcoidosis, still remains unanswered. [5] Some believe it is a variant of nodular sarcoidosis e.g. nodular sarcoidosis with necrosis.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing sarcoid granulomatosis: a case report and review of progresses in this disease

Epping¹,

Schwengle²,

Aliredjo³

et al. 2011

Health

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We present the case of a young male who visited the emergency room with progressive dyspnea and left sided chest pain. A chest X-ray was performed which showed a pattern of diffuse nodular and reticular opacities. The diagnosis of Necrotizing Sarcoid Granulomatosis (NSG) was made by histopathological examination of a lung biopsy specimen and by excluding other causes of granulomatous disease. He was treated with corticosteroids. Because of persistent extrapulmonary (ocular) involvement a maintenance dose of prednisone was needed. Necrotizing Sarcoid Granulomatosis is a granulomatous disease with necrosis and vasculitis of unknown cause. The resemblance between NSG and (nodular) sarcoidosis is strong, but subtle differences exist. The prognosis is good and therapy is usually not necessary. However in some cases there is a need for therapy with corticosteroids, depending on the involved organs and/or the degree of impairment.Keywords: Necrotizing Sarcoid Granulomatosis; Sarcoidosis; Extrapulmonary Involvement; Computed Tomography; Pathology CASE PRESENTATIONA 21 year old non-smoking male was presented at the emergency department of our hospital. He suffered from pain in his right shoulder and on the left side of his chest, with progressive shortness of breath for two days. He had a productive cough with clear blank sputum. There was no haemoptysis, nor were there constitutional symptoms like fever or night sweats. There were no complaints that could be related to a vasculitis-like disease, e.g. vision problems, joint aches, skin problems or abdominal discomfort. He had a blank history, and didn't use any medication.Our patient was tachypnoeic with an oxygen saturation of 98% with 3 litres of supplemental oxygen per minute. His blood pressure was 110/70 mmHg with a regular pulse of 115/minute. He had a low grade fever, with a temperature of 38,2 o C. There were no palpable lymph nodes. Chest examination revealed wheezing on both sides and crackles at the bases. There were no other abnormalities at the physical examination.The posteroanterior view of the chest X-ray showed diffuse reticular and nodular opacities of both lungs (Figure 1). A computed tomography of the chest and upper abdomen (Figure 2) showed mediastinal and right hilar lymphadenopathy. Diffusely dispersed alveolar opacities were present in both lungs, which were more pronounced in the lower lobes.Laboratory findings showed an elevated erythrocyte sedimentation rate. The C-reactive protein and white cell counts were both minimally elevated. The serum angiotensin converting enzyme (ACE) level was low. Antinucleair antibodies (ANA) and anti-neutrophil cytoplasmatic antibodies (ANCA) were both negative. Analysis of his urine showed no abnormalities. Pulmonary function tests showed a restrictive pattern (TLC = 53% of reference) with a diminished diffusion capacity (D L CO = 48%). Arterial blood gas analysis (ABGA) breathing room air showed a mild hypoxemia (pO 2 9.6 kPa), with normocapnia (pCO 2 5.1 kPa).We performed extensive microbiological test...

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Pathology of Sarcoidosis

Cited by 167 publications

References 85 publications

Pediatric-onset adult type sarcoidosis: A case report

Pediatric-onset adult type sarcoidosis: A case report

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Necrotizing sarcoid granulomatosis: a case report and review of progresses in this disease

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