Sarcoidosis lymph nodes
Sarkoidoz - Systemic granulomatous disease, in which may be affected all the organs and tissues of the body. Favourite localization granulomas are the lymph nodes (mediastinal, Neck, axillary) and light. In most cases the disease is chronic.
In the development of sarcoidosis mark three stages:
- Hyperplastic;
- Granulomatous;
- Fibro-gialinoznuyu.
In step hyperplastic observed in punctate reticular cells in large numbers, conglomerations of epithelioid cells and lymphocytes. Diagnosis according to cytology is not possible.
In granulomatous stage in the preparation of the field found epithelioid cells, cytoplasmic granules are rich in glycogen and RNA, and sometimes lipid, while it in stained contains many of the same round form small voids.
For sarkoidoznoy granulomas characterized by different amounts and different forms of giant cell type Pirogov-Langhans, often a lot of them. In the cytoplasm of giant and epithelioid cells are found peculiar inclusion - asteroid bodies and basophilic inclusion Schaumann.
Asteroid bodies (star) It has a body (Centre), which runs processes; their number may reach 20 and more. Asteroid bodies PAS-positive. Many authors believe their derivatives cytoplasm, t. it is. referred to microfilaments and microtubule apparatus of the cell.
Inclusions Schaumann are calcium-birefringent inclusions, sometimes occupying the entire cytoplasm of giant cells. The nature of these inclusions not fully understood.
According to the literature, asteroid bodies and the inclusion of Schaumann are rarely seen in sarcoidosis. Often there are macrophages and transitional forms between macrophages and epithelioid cells. May be found scraps of capillaries, what matters for the differential diagnosis with tuberculous granulomas sarkoidoznoy.
When sarkoidoznoy granuloma necrosis and no inflammatory response of the surrounding tissue.
When fibrous gialinoznoy stage of the disease punctate found in a small number of lymphocytes, fibroblasts, macrophages and in some places there are epithelioid cells.
