Characteristics of the sarcoidal granuloma in transbronchial lung biopsy

Abstract

Sarcoidosis is a multisystemic disease of unknown etiology, which most commonly affects lungs and is characterized by the presence of non necrotizing lymphocyte-epitheloid granulomas. We used the material obtained by transbronchial biopsies of 34 patients having sarcoidosis, 22 (64,7%) women and 12 (35,3%) men, with the mean age of 43,2 years. In this paper, histological characteristics of 102 sarcoid granulomas were established. The quantity, composition and localization of cellular and fibrous elements were determined by quantitative analysts of stereometry, using the numerological density as a stereological variable. The sarcoid granuloma, with the average size of 356x254x microns is most commonly localized in the perivascular region (47% of granulomas). In the central part of the granulomas epitheloid cell, giant cells, macrophages, lymphocytes and plasma cells were found with thw average density of 111751mm-3. The lymphocytes were the most common cell type. followed by three times fewer number of epitheloid cells. The giant cells, most commonly of Langhans cell type, were present in 62% of granulomas. The average numerical density of all types of cells in the peripheral part of granulomas was 241346mm'3. In the periphery of the granuloma the most dominant cell population were lymphocytes, which represented 91,5% of all cellular elements. Fibrinoid necrosis was found in 2% of all granulomas. Acidoresistent bacilli were notfound. The average density of all cell types in the central part of granulomas was 111751mm-3 with lymphocytes and epitheloid cells being the most common cells. The average numerical density of all cell types in the peripheral part of the granulomas was 241346mm3, with the domination of lymphocytes with 91,5%. Fibrinoid necrosis was present in 2% of granulomas.