]> 2026-07-31T10:04:36+00:00 WBR0776 0 en Giant cells, granuloma formation with caseating necrosis Caseating necrosis within intrathoracic granulomas is usually indicative of a tuberculosis infection. Giant cells, non-caseating granuloma formation Patients with sarcoidosis have multiple noncaseating epithelioid-cell (giant cell) granulomas. Inflammatory reaction with molds branching at acute angles Molds branching at acute angles are seen in aspergillomas usually growing in immunocompromised patients with previous cavitary disease colonized by Aspergillus spp. Multiplying type II pneumocytes Type II pneumocytes are seen in the alveolar spaces and multiply during lung injury to restore parenchymal integrity. Nests or cords of uniform cells with central nuclei Carcinoid tumors are usually characterized by nests or cords of uniform cells with central nuclei. Sarcoidosis is a systemic disease characterized by the development and accumulation of multiple systemic granulomas. Sarcoidosis may involve virtually any organ but is classically most common in the lungs, liver, eyes, and skin. Symptoms of fatigue, night sweats, and weight loss are common at presentation. Löfgren's syndrome, a possible presentation of sarcoidosis consists of arthritis, erythema nodosum, and bilateral hilar adenopathy, and can be seen in up to 35% of patients. Although all racial and ethnic groups can have sarcoidosis, African Americans are 3 times more likely than Caucasians to develop the disease. Diagnosis is usually with a combination of clinical and radiologic findings supported by histopathological evidence of noncaseating epithelioid-cell granulomas with absence of any causative organisms or particles. Granulomas classicaly produce angiotensin-converting enzyme (ACE) with 60% of patients having elevated serum levels (not-diagnostic). Treatment is usually with corticosteroids although therapy is not indicated for everyone. Two thirds of patients recover completely within 10 years of diagnosis.<br/> '''Educational Objective:''' Sarcoidosis is characterized by the development of multiple noncaseating epithelioid-cell granulomas.<br/> '''References:''' Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357(21):2153-65. Pathophysiology B Pulmonology 2020-10-28T01:40:43Z 2459150.5699421 WBR0776