Necrotizing Sarcoid Granulomatosis - is it different from nodular sarcoidosis?

Abstract

Nodular aggregates of granulomas in NSG were similar to those seen in nodular sarcoidosis. Granulocytic vasculitis, a hallmark of WG was not seen in any of the NSG cases. Granulomatous vasculitis was a common feature in cases of NSG, and did not differ from that seen in sarcoidosis. The only unique feature of NSG is infarct-like necrosis, induced by the vasculitis, which might also be interpreted as a function of the duration of the vasculitis, leading ultimately to vascular obstruction. NSG based on our morphologic findings is best classified as a variant of nodular sarcoidosis. In contrast to our findings in sarcoidosis mycobacterial DNA was not found in any of the 10 cases.

Necrotizing Sarcoid Granulomatosis With an Uncommon Manifestation: Clinicopathological Features and Review of Literature

“…Cough is the most common clinical manifestation of NSG, followed by pleural chest pain, dyspnea, fever, and constitutional symptoms of weight loss. 6,18 However, ϳ25% of patients are paucisymptomatic/asymptomatic. 20 Limited information is available in the literature regarding laboratory tests.…”

“…18 Indeed, there are some similarities between sarcoidosis and NSG. Both diseases have a favorable prognosis, a similar immune mechanism, and distribution of granulomas.…”

“…Moreover, the vasculitis of Wegener's granulomatosis is more necrotizing and often suppurative. 18,19,27 A differential diagnosis with infection is more difficult: conventional microbiological analysis and use of overall tissue ancillary techniques such as special stains, immunohistochemistry, and molecular analysis (the latter for mycobacterial detection) are important. Above all, the use of a highly specific and sensitive molecular technique such as nested polymerase chain reaction for mycobacterial detection is mandatory.…”

A case of neurosarcoidosis with necrotizing granuloma expressing angiotensin-converting enzyme

“…The characteristic histological findings have been reported to be the coagulative central necrosis along with noncaseating granulomas accompanied by a moderate to intense inflammatory reaction involving lymphocytes, plasma cells, and macrophages [14]. The pathogenesis of NSG has been reported to be a hypersensitive reaction due to the vascular involvement and granulomatous inflammation [15]. Further studies will be required to make clear the precise mechanism of NSG.…”

Association of the Rares: the Occurrence of Chronic Myelomonocytic Leukemia During the Course of Necrotising Sarcoid Granulomatosis

“…Akciğer tutulumu yanında diğer organların tutulumu da görülebilmektedir. NSG'nin sarkoidozun bir alt tipi olduğu, hatta nodüler sarkoidoz ile aynı olduğu öne sürülmektedir (2)(3)(4). Sarkoidoz ve NSG monositoz nedenleri arasında yer almaktadır (5).…”