Sarcoidosis is a multisystemic disease of unknown etiology, which most commonly affects lungs and is characterized by the presence of non necrotizing lymphocyte-epitheloid granulomas. We used the material obtained by transbronchial biopsies of 34 patients having sarcoidosis, 22 (64,7%) women and 12 (35,3%) men, with the mean age of 43,2 years. In this paper, histological characteristics of 102 sarcoid granulomas were established. The quantity, composition and localization of cellular and fibrous elements were determined by quantitative analysis of stereometry, using the numerological density as a stereological variable. The sarcoid granuloma, with the average size of 356x254x microns is most commonly localized in the perivascular region (47% of granulomas). In the central part of the granulomas epitheloid cell, giant cells, macrophages, lymphocytes and plasma cells were found with thw average density of 111751mm 3. The lymphocytes were the most common cell type, followed by three times fewer number of epitheloid cells. The giant cells, most commonly of Langhans cell type, were present in 62% of granulomas. The average numerical density of all types of cells in the peripheral part of granulomas was 241346mm*. In the periphery of the granuloma the most dominant cell population were lymphocytes, which represented 91,5% of all cellular elements. Fibrinoid necrosis was found in 2% of all granulomas. Acidoresistent bacilli were not found. The average density of all cell types in the central part of granulomas was 111751mm*, with lymphocytes and epitheloid cells being the most common cells. The average numerical density of all cell types in the peripheral part of the granulomas was 241346mm 3, with the domination of lymphocytes with 91,5%. Fibrinoid necrosis was present in 2% of granulomas.
Williams WJ. The fine structure of sarcoid and tuberculous granulomas. *Postgrad Med J*. 1970;46:496–500.
2.
Basset F, Socer P, Hance A. Sarcoidosis – from granuloma formation to fibrosis. *Sarcoidosis and Other Granulomatous Disorders*. ESPBV. 1988;235–46.
3.
Lacronique J, Bernardin JJ, Soler R. Alveolitis and granulomas – sequential course in pulmonary sarcoidosis. In: *IX International Conference on Sarcoidosis*. 1981. p. 36–43.
4.
Sarcoidosis DB. Monografija. 1975;
5.
Williams WJ. Immunology. 1985.
6.
Kosjerina Z. *Analiza i komparacija patološko histoloških promena kod idiopatskog fibrozirajućeg alveolitisa, egzogenog alergijskog bronhioloalveolitisa i sarkoidoze pluća*. Magistarski rad Beograd. 1989;
7.
Soler P, Basset F. Morphology and distribution of the cells of a sarcoid granuloma: ultrastructural study of serial sections. *Ann N Y Acad Sci*. 1976;278:147–60.
8.
Elias PM, Epstein WL. Ultrastructural observations on experimentally induced foreign-body and organized epithelioid-cell granulomas in man. *Am J Pathol*. 1968;52(6):1207–23.
9.
Epstein WL, Fukuyama K. Dear epithelioid cell, tell us what you do. *Sarcoidosis*. 1989;6:5–6.
10.
Studdy PR. Sarcoidosis. 1990.
11.
Williams WJ. Granulomas in the diagnosis of sarcoidosis – state of art. *Sarcoidosis and Other Granulomatous Disorders*. ESPBV. 1988;661–73.
12.
Chioli M. Immunohistochemical analysis of sarcoid granulomas: evidence of proliferating lymphocytes and presence of cells with cytoplasmic interleukin 1. *Sarcoidosis and Other Granulomatous Disorders*. ESPBV. 1988;255–8.
13.
Muler-Hermelink HK, Kamiyama R, Kaiserling E, Lennert K. Lymph node findings in sarcoidosis: light microscopical, ultrastructural and enzyme histochemical results. In: *VIII International Conference on Sarcoidosis*. 1980. p. 23–9.
14.
Warwick MT. The immunology of sarcoidosis. 1978.
15.
Tamura S, Kumazaki S, Mishima H, Uzawa T, Mori Y. Electron microscopic study on pulmonary sarcoidosis. In: *XII World Congress on Sarcoidosis*. 1991. p. 80.
16.
Rossow DJ, Case CC, Joubert. The ultrastructure of sarcoid granulomas in the lung. In: *XII Congress on Sarcoidosis*. 1991. p. 119.
17.
Poletti V, Patelli M, Ferracini R, Spiga L. Granulomatous lung disorders: a TBB study. In: *XI World Congress on Sarcoidosis*. 1987. p. 79.
18.
Kosjerina Z, Zaric B, Vuckovic D, Lalosevi D, Djenadic G, Murer B. The sarcoid granuloma: “epithelioid” or “lymphocytic-epithelioid” granuloma? *Multidisciplinary Respiratory Medicine*. 2012;7(11):1–5.
19.
Carrington CB. Structure and function in sarcoidosis. *Ann N Y Acad Sci*. 1976;278:265–83.
20.
Kitaichi M. Pathogenesis of sarcoidosis from the viewpoint of the comparative pulmonary pathology of granulomatous lung diseases. 1991.
21.
Thomas PD, Huninghake GW. Current concepts of pathogenesis of sarcoidosis. *Am Rev Respir Dis*. 1987;135:747–60.
22.
Ferluga D. Histomorfološki aspekti sarkoidoze različitih organa. *Pluć Bol Tuberk*. 1973;2:40–54.
23.
Williams WJ. The pathology of sarcoidosis. In: *Sarcoidosis*. 1985. p. 65–83.
24.
Rosen Y. Sarcoidosis. In: *Pulmonary Pathology*. 1988. p. 417–39.
25.
Rott T, Ferluga D, Sorli J, Fink I, Welle K. Histopatološka analiza biopsija u bolesnika s intratorakalnom sarkoidozom. *Pluć Bol Tuberk*. 1981;33:315–20.
26.
Kališnik M. *Temelji stereologije*. *Acta Stereologica*. 1985;4:1–148.
27.
Weibel ER. Design of the mammalian respiratory system. *Respir Physiol*. 1981;44:39–59.
28.
Hsu RM, AF C, JF T. Histologic, microbiologic, and clinical correlates of the diagnosis of sarcoidosis by transbronchial biopsy. *Arch Pathol Lab Med*. 1996;120:364–8.
29.
Williams WJ. Granulomas in the diagnosis of sarcoidosis – state of art. In: *Sarcoidosis and Other Granulomatous Disorders: Proceedings of the XI World Congress on Sarcoidosis and Other Granulomatous Disorders*. 1987. p. 661–73.
30.
Kita S, Tsuda T, Sugisaki K, Miyazaki E, Matsumoto T. Characterization of distribution of T lymphocyte subsets and activated T lymphocytes infiltrating into sarcoid lesions. *Intern Med*. 1995;34:847–55.
31.
Oliver SJ, Kikuchi T, Krueger JG, Kaplan G. Thalidomide induces granuloma differentiation in sarcoid skin lesions associated with disease improvement. *Clin Immunol*. 2002;102:225–36.
32.
Zissel G, Prasse A, Müller-Quernheim J. Sarcoidosis – immunopathogenetic concepts. *Semin Respir Crit Care Med*. 2007;28:3–14.
33.
Danila E, Zurauskas E. Diagnostic value of epithelioid cell granulomas in bronchoscopic biopsies. *Intern Med*. 2008;47:2121–6.
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