Sarcoidosis结节病课件.ppt

Sarcoidosis;What is Sarcoidosis?;Etiology;Etiology;Incidence and Prevalence;Incidence and Prevalence;Pathophysiology;LANGHANS GIANT CELL Langhans giant cell in center of granuloma is surrounded by epithelioid cells . ;ADVANCED COLLAGENOUS FIBROSIS Elongated fibroblasts (FB) with extensive collagenous tissue (C). Giant cells (arrows);Pathophysiology;CYTOPLASMIC INCLUSION BODY Schaumann body (arrow) is common in sarcoidosis but is nonspecific. ;Pathophysiology;Clinical Manifestations;Clinical Manifestations;Lungs;Noncaseating granuloma in lung is the characteristic lesion of sarcoidosis. ;CASEOUS NECROSISCellular destruction in TB granuloma appears as clumped debris (arrows). This necrosis does not occur in sarcoidosis. ;M. tuberculosis BACILLI Caseous necrosis is most common in TB, but Gram negative, acid fast bacilli must be identified to make the diagnosis.;SUBPLEURAL GRANULOMA IN LUNG ;Eyes;CONJUNCTIVITIS ;PAPILLEDEMA Often associated with 7th nerve facial palsy. ;Skin;NAKED GRANULOMA Young granulomas (arrows) in the skin with no surrounding rim of mononuclear cells. ;ERYTHEMA NODOSUM These reddish raised lesions. ;Skin;LUPUS PERNIO Facial lesions are most common, but the extremities and buttocks can be involved. ;LUPUS PERNIO Indurated and violaceous range from a few small lesions to large lesions;SMALL NODULES Papules and nodular lesions, can be found anywhere on the body. Papules are often multiple while nodules are often solitary. ;RAISED PLAQUESThese raised plaques are the result of coalescence of nodules.;PSORIASIS LIKE LESIONS These small white lesions closely resemble psoriasis.;Liver;SPLEEN LIVER GRANULOMAS The small low attenuation lesions in the liver and spleen in sarcoidosis.;EARLY COLLAGEN FORMATION Extracellular collagen (C) is being produced by fibroblasts;Musculoskeletal;PUNCHED OUT LYTIC LESIONS Focal osteolytic lesions in the fingers are most common abnormality.;LACY TRABECULAR PATTERN Osteolysis has left a lacy trabecular pa