Cutaneous sarcoidosis histopathology

Schaumann bodies sarcoidosis
Sarcoidosis libre pathology
Sarcoidosis lymph node histology

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ABSTRACT

A 52-year-old woman presented with erythematous nodules and swelling on both upper eyelids. She had a surgical history of blepharoplasty about 10 years previously. Skin biopsy revealed non-caseating granulomas in the dermis. Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) testing of the tissue sample was positive. In addition, the serum interferon gamma release assay (IGRAs) result was positive. Based on the positive result of MTB PCR and IGRAs, a diagnosis of tuberculosis was made. Despite a 2-month treatment with anti-tuberculosis medication, the skin lesions worsened. An additional skin biopsy was taken and AFB stain, AFB culture, and MTB PCR of the tissue were all negative. Four months after systemic corticosteroid treatment, the skin lesion had almost cleared. Considering that there have been many reports of positive results of MTB PCR in sarcoidosis tissue and IGRAs, a diagnosis of tuberculosis based on the results of PCR and IGRAs needs to be interpreted with caution. Also, evaluation of other organ involvement including the lungs can be help

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Neurossarcoidose

Neurossarcoidose se refere a um tipo de sarcoidose, uma doença imunomediada caracterizada por inflamação granulomatosa dos órgãos afectados.^[1] Granulomas epitelioides compactos, bem formados, coalescentes, não necrosantes ou minimamente necrosantes, com linfócitos dispersos, são as características patológicas da doença.^[2] Os órgãos mais frequentemente afectados incluem os pulmões (90%), a pele (∼15%), os olhos (10-30%), o fígado (20-30%) e os gânglios linfáticos (10%-20%).^[1]^[3]

O envolvimento neurológico da sarcoidose (neurosarcoidose, NS) pode envolver o Sistema Nervoso Central (SNC) ou o sistema nervoso periférico (SNP) ou ambos e pode causar uma morbilidade substancial. Historicamente, tem sido referido que a NS ocorre em 5%-10% de todos os doentes com sarcoidose, embora este número possa refletir um viés de amostragem de coortes centradas na sarcoidose pulmonar. A NS clinicamente oculta é identificada na autópsia em 15%-25% dos doentes, e um estudo de 2017 identificou a NS em 234/290 (34%) dos doentes com sarcoidose sistémica.^[4] As mani

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Abstract

OBJECTIVE:

To determine the frequency of and the factors related to delayed diagnosis of sarcoidosis in Brazil.

METHODS:

We evaluated patients with a biopsy-proven diagnosis of sarcoidosis, using a questionnaire that addressed the following: time since symptom onset and since the first medical visit; and the number and specialty of the physicians visited. We divided the patients by the timeliness of the diagnosis-timely (< 6 months) and delayed (≥ 6 months)-comparing the two groups in terms of systemic and pulmonary symptoms; extrathoracic involvement; spirometric data; radiological staging; level of education; income; and tuberculosis (diagnosis and treatment).

RESULTS:

We evaluated 100 patients. The median number of physicians consulted was 3 (range, 1-14). In 11 cases, sarcoidosis was diagnosed at the first visit. In 54, the first physician seen was a general practitioner. The diagnosis of sarcoidosis was timely in 41 patients and delayed in 59. The groups did not differ in terms of gender; race; type of health insurance; lev