Home > E. Pathology by systems > Skin > cutaneous sarcoidosis
cutaneous sarcoidosis
Monday 23 May 2016
| PO |
Definition: Sarcoidosis has granulomas composed of histiocytes surrounded by lymphocytes, without necrosis.
Images
cutaneous sarcoidosis
Microscopy
Inflammatory and granulomatous reactions with dense superficial and deep lymphocytes, eosinophils and plasma cells
Variable parakeratosis, spongiosis, acanthosis and epidermal erosion
May have lymphoid germinal centers resembling lymphoma with destruction of adnexae and atypia
Dense, noncaseating granulomatous infiltrate in the dermis extends into subcutaneous fat;
- granulomas are discrete and uniform in size and shape;
- composed of epitheloid histiocytes with abundant eosinophilic cytoplasm and oval nuclei containing a small central nucleolus
Variable Langhans giant cells, and scattered lymphocytes
Discrete, small central foci of fibrinoid necrosis are present; also transepidermal elimination
Schaumann bodies (calcium and protein inclusions inside of Langhans giant cells as part of a granuloma; basophilic laminated rounded conchoidal structures),
asteroid bodies (small, intracytoplasmic, eosinophilic star shaped structure also present in tuberculoid leprosy, berylliosis and atypical facial necrobiotic xanthogranuloma),
Hamazaki-Wesenberg bodies (peculiar PAS+ inclusions, may be large lysosomes containing hemolipofuscin)
Differential diagnosis
cutaneous granulomatous diseases
- cutaneous tuberculosis
- leprosy
- cutaneous berylliosis
- cutaneous fungal infection
- cutaneous Crohn disease
- foreign body granuloma
See also
sarcoidosis