Problems in histological interpretation in sarcoidosis

Abstract

Summary The sarcoid granuloma has a histological structure that is similar to that seen in many other diseases. Some of its diagnostic features are negative, but an accurate diagnosis can be made from biopsy tissues if numerous, monotonously uniform granulomata are present. Histological confidence is often proportional to the number of granulomata seen in the specimen. Mediastinal lymph nodes taken at mediastinoscopy have been positive in 90% of seventy-four patients with sarcoidosis. Problems in the histological interpretation of Kveim biopsies may be due to failure to include the injection site in the biopsy, to inadequate sectioning of the specimen and to equivocal cellular reactions. Despite these difficulties, dual blind reading of sections of mediastinal lymph nodes and Kveim reaction biopsies from patients with sarcoidosis has shown that the observer variation that is likely to be of clinical significance is approximately 5% in each group.

Sarcoid-like disorder of the intracranial optic nerve: Clinicopathological report of two cases

“…Other disease processes which may provoke a granulomatous inflammation must be excluded (Hook, 1954;Drury, 1970;Cares, 1972;Nurick et al, 1972). Reaction to intracranial foreign body seems extremely unlikely in our cases, neither of which had suffered severe head trauma or had undergone previous neurosurgery or neuroradiological examination.…”

The Arthritis Associated With Crohn's Disease: A Family Study

“…The affection of the perineal region, a common site for diagnostic biopsy, by Crohn1s disease (Mountain, 1970) also contrasts with its non-involvement in sarcoidosis (Israel, 1970 (Drury, 1970) gives a positive response in 72 per cent of patients with sarcoidosis (Mikhail and Mitchell, 1970), Post-infective arthritis characteristically occurs 5 to 14 days after the onset of the gut symptoms and affects large joints more frequently than small (Berglof, 1963 (1967) as -1.…”