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Sarcoidosis

Etiology: • Completely unknown.

Pathogenesis: • The constitutional symptoms are due to the secretion of cytokines by the activated macrophages called epitheloid cells. • The reduction in respiratory function is due to extensive involvement of lung parenchyma by disease.

Epidemiology: • Much more common in black people than in caucasians. • Almost unheard of in Asians. • Somewhat more common in females.

General Gross Description: • Often, there is no gross alteration in an organ affected by sarcoidosis. • Coalesence of granulomas in advanced disease may give rise to hard nodules. • Lymph node and splenic enlargement without obvious lesions is common.

General Microscopic Description: • Sarcoid is typified by non-caseating granulomas, with epitheloid cells and Langhans giant cells. • Two formations seen in some of these giant cells are (1) laminated, calcified structures called Schaumann bodies or (2) star-shaped "asteroid bodies." • While they are often seen in sarcoidosis, these structures are not pathognomonic of this disease.

Clinical Correlations: • Sarcoid may present as a vague, constitutional disorder with fever, weight loss and lymph-adenopathy. • Later, with extensive involvement of the lung parenchyma, some compromise of respiratory function may ensue. • The course of the disease is unpredictable.

References: •Robbins "Pathologic Basis of Disease". (Cotran, Kumar and Robbins, Eds.) 5th Edition. pp 712.