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Histopathologic Aid to Diagnosis of Sarcoidosis: Report of 8 Cases

Jane Manonukul MD*, Rungsima Wanitphakdeedecha MD**, Wanee Wisuthsarewong MD***, Panitta Thirapote MD*

Affiliation : * Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University ** Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University *** Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University

Sarcoidosis is a multisystemic disease of unknown etiology. The disease is common in blacks and is very rare in Thailand. It presents as one of the most variable manifestations usually affecting the lungs and intrathoracic lymph nodes. Other organs such as liver, spleen, joints and eyes including skin are also in- volved. The common cutaneous lesions are maculopapular, erythematous plaque, subcutaneous nodule, scar and lupus pernio. No reliable indicator is useful for diagnosis except the histopathologic change which is the only way for approaching this disease. Sarcoidosis is the disease of exclusion. Various infections producing granulomas should be excluded histologically. The ultimate diagnosis requires clinical correlation, labora- tory investigations, chest X-ray as well as available tissue culture. Herein, the authors reported eight cases of sarcoidosis by retrospective study primarily diagnosed by histopathological findings at Siriraj Hospital from January, 1997 to December, 2004 with many different clinical presentations. Despite the diverse clinical pictures, interestingly, the presented patients almost had the same histopathologic findings as small, uniform, discrete naked granulomas usually without necrosis. These findings act as a hallmark for diagnosis of this disease.

Keywords : Sarcoidosis, Histopathology, Diagnosis


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JMed Assoc Thai
MEDICAL ASSOCIATION OF THAILAND
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