BACKGROUND: Currently incidence and prevalence of sarcoidosis are increasing. Sarcoidosis is a systemic granulomatous lung disease of unknown aetiology, which is characterised by the involvement of different organ systems, variable disease course affecting young people and possessing an important issue in the modern world. The disease is extremely heterogeneous with an unpredictable clinical course. Interesting clinical cases are described in which, with a sufficient illustration of the stages of the course and diagnosis of sarcoidosis of the lungs and peripheral lymph nodes, the diagnosis was difficult. Late diagnosis and lack of correct therapy make prognosis in patients with lung sarcoidosis unfavourable. AIM: To conduct a morphometric study with the determination of the cellular composition of granulomas for the differential diagnosis of morphogenesis of granulomas in sarcoidosis and pulmonary tuberculosis. MATERIAL AND METHODS: An analysis of transthoracic biopsy of 89 patients with a verified diagnosis of sarcoidosis of the lungs and disseminated form of pulmonary tuberculosis was carried out. The resulting lung tissue material was carried out according to the standard histological method; conducted morphometric analysis. RESULTS: Sarcoid granulomas are characterised by an increase in lymphocytes, indicating the immune character of the lesion, an increase in fibroblasts, fibrocytes, and signs of activation of angiogenesis. While for TB granuloma an increase in the number of granulocytes and epithelioid cells is characteristic. These morphological criteria for the diagnosis of sarcoidosis of the lungs and lymph nodes are necessary for use in the practice of pathologists to verify the clinical diagnosis. CONCLUSION: Developed morphological and morphometric criteria for the differential diagnosis of sarcoidosis and pulmonary tuberculosis must be used in the practice of a pathologist to verify the clinical diagnosis, which will determine the adequate tactics of examination, administration, correction of the disease, and evaluation of the prognosis of the disease, taking into account identified clinical and laboratory data, results of instrumental research methods.
The article presents an interesting clinical observation, in which, with sufficient illustration of the stages of the course and diagnosis of sarcoidosis of the lungs and peripheral lymph nodes, the diagnosis was difficult to diagnose. Late diagnosis and lack of correct therapy makes a prediction in patients with lung sarcoidosis unfavorable. These morphological criteria for the diagnosis of sarcoidosis of the lungs and lymph nodes are necessary for use in the practice of a pathomorphologic physician in order to verify the clinical diagnosis, which will allow us to determine the adequate tactics for examining, administering, correcting therapy and assessing the disease prognosis, taking into account the clinical and laboratory data revealed, the results of instrumental methods research.Key words: granulomatous lung diseases -sarcoidosis -granuloma. ТҰЖЫРЫМДАМАОсы мақалада қызықты клиникалық мысал келтірілген, өкпе және шеткері лимфа түйіндерінің саркоидозының ағымын және диа-гностика кезеңдеріне жеткілікті иллюстрациялар болса да, диагноз құру қиындық тудырған.Өкпе саркоидозымен науқастарда кеш диагностикалаужәнедұрыс ем шараларының болмауы аурудың болжамын қатерлендіреді. Өкпе және шеткері лимфа түйіндерінің саркои-дозын диагностикалаудың морфологиялық критерии мәліметтері клиникалық диагнозды нақтылау мақсатында дәрігер-патоморфологтың тәжірибесінде қолдану үшін қажет. Зерттеудің дұрыс жолын, емдеудің коррекциясымен ауру болжамын бағалаумен, клиника-лабораторлық және құрал -жабдықтық зерттеу нәтижелерінің мәліметтерді анықтауға мүмкіндік береді.Маңызды сөздер: гранулематозды өкпе аурулары -саркоидоз -гранулема.ОСОБЕННОСТИ КЛИНИКО-МОРФОЛОГИЧЕСКОЙ ДИАГНОСТИКИ САРКОИДОЗА ЛЕГКИХ Майда Масхаповна Тусупбекова1, Роза АгубаевнаБакенова2, Лейла Медеубаевна Стабаева1, Райхан Жаксылыковна Ныгызбаева1, Гульназира Назымхикматовна Иманбаева1 1Карагандинский государственный медицинский университет 2Больница Медицинского Центра Управления делами ПрезидентаРеспублики Казахстан РЕЗЮМЕ В статье приведено интересное клиническое наблюдение, в котором, при достаточной иллюстрации этапов течения и диагностики сар-коидоза легких и периферических лимфатических узлов, постановка диагноза была затруднена.Поздняя диагностика и отсутствие коррект-ной терапии делает прогноз у больных саркоидозом легких неблагоприятным.Данные морфологические критерии диагностики саркоидоза легких и лимфотических узлов необходимы для использования в практике врача-патоморфолога с целью верификации клинического диа-гноза, что позволит определить адекватную тактику обследования, введения, коррекцию терапии и оценке прогноза заболевания с учетом, выявленных клинико-лабораторных данных, результатов инструментальных методов исследования.Ключесвые слова: гранулматозные заболевания легких -саркоидоз -гранулема.
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