Pathology of Sarcoidosis

Giulio Rossi, Alberto Cavazza, Thomas V. Colby

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Pathologists are frequently involved in the diagnosis of sarcoidosis on conventional biopsies or examining bronchoalveolar lavage fluid and assisting bronchoscopists when performing bronchial or transbronchial biopsies or transbronchial needle aspiration (TBNA)/endobronchial ultrasound (EBUS)-guided biopsies of enlarged lymph nodes. Histology generally does not pose difficult tasks in the correct clinical and imaging scenario, but atypical forms of sarcoidosis exist, and in these cases, the diagnosis may become difficult. When faced with granulomas in the lung, the evaluation of their qualitative features, anatomic distribution, and accompanying findings usually allows the pathologist to narrow considerably the differential diagnosis. The final diagnosis always requires the careful integration of the histology with the clinical, laboratory, and radiologic findings. How robust is the histologic component of the diagnosis varies from case to case, and the pathologist should always clearly discuss this point with the clinician; in general, the weaker the histology is, the stronger should be the clinical–radiologic findings, and vice versa. The differential diagnosis of sarcoidosis includes granulomatous infections, hypersensitivity pneumonitis, pneumoconiosis, autoimmune diseases (e.g., inflammatory bowel disease, primary biliary cirrhosis, several collagen vascular diseases (particularly Sjögren), drug reactions, chronic aspiration, and even diffuse fibrosing diseases. In this review, conventional and unusual histologic findings of pulmonary sarcoidosis are presented, highlighting the role of the pathologist and discussing the main differential diagnoses.

Original languageEnglish
Pages (from-to)36-44
Number of pages9
JournalClinical Reviews in Allergy and Immunology
Volume49
Issue number1
DOIs
Publication statusPublished - Aug 22 2015

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Sarcoidosis
Pathology
Histology
Differential Diagnosis
Biopsy
Pulmonary Sarcoidosis
Extrinsic Allergic Alveolitis
Pneumoconiosis
Collagen Diseases
Biliary Liver Cirrhosis
Bronchoalveolar Lavage Fluid
Granuloma
Vascular Diseases
Inflammatory Bowel Diseases
Autoimmune Diseases
Needles
Lymph Nodes
Lung
Pathologists
Infection

Keywords

  • Biopsy
  • Granuloma
  • Infection
  • Lung
  • Lymphatics
  • Necrosis
  • Sarcoidosis

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Pathology of Sarcoidosis. / Rossi, Giulio; Cavazza, Alberto; Colby, Thomas V.

In: Clinical Reviews in Allergy and Immunology, Vol. 49, No. 1, 22.08.2015, p. 36-44.

Research output: Contribution to journalArticle

Rossi, Giulio ; Cavazza, Alberto ; Colby, Thomas V. / Pathology of Sarcoidosis. In: Clinical Reviews in Allergy and Immunology. 2015 ; Vol. 49, No. 1. pp. 36-44.
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