Sarcoidosis - Diagnosis and Management by M. Motamedi

By M. Motamedi

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G. dyspnea) or functional parameters such as spirometry nor the six-minute walk test (Yeager et al. 2005; Judson et al. 2008; Baughman, Sparkman, and Lower 2007). Furthermore, there is poor interobserver reliability among various specialists according to a recent study of chest roentgenograms in sarcoidosis patients during a trial of infliximab (Baughman et al. 2009). 50 Sarcoidosis Diagnosis and Management The characteristic histology of sarcoidosis is the granuloma formation. Granulomas may be seen along the lymphatics of the bronchovascular bundle, interlobular septa, major fissures and subpleural areas.

Endoscopic findings in sarcoidosis. Characteristics and correlations with radiographic staging and bronchial mucosal biopsy yield. Ann Otol Rhinol Laryngol. 1981;90 :339-43. [20] Shorr AF, Torrington KG, Hnatiuk OW. Endobronchial biopsy for sarcoidosis: A prospective study. Chest 2001; 120:109-114. [21] Drent M, Mansour K, Linssen C. Bronchoalveolar lavage in Sarcoidosis. Semin Resp Crit Care Med 2007;28:486-495. [22] Costabel U, Zaiss A, Wagner DJ, et al. Value of bronchoalveolar lavage lymphocyte subpopulations for the diagnosis of sarcoidosis.

3. Immunohistochemical characteristics of cells constituting granulomas Granulomas are usually accompanied by CD4+ T-lymphocytes in the center and CD8+ Tlymphocytes in the periphery (Fig. , 2007; Noor & Knox, 2007). These observations are compatible with the below-mentioned postulation that granulomas are caused by cellmediated immunity, and that CD4+ T-lymphocytes are primary cells that recruit other Tlymphocytes and macrophages. Epithelioid cells and giant cells as well as other macrophages including alveolar macrophages in the lung and sinus histiocytes in the lymph nodes are immunohistochemically positive for CD68, a marker for pan-macrophages.

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