Sarcoidosis: A Clinicopathologic Review of Three Hundred Cases, Including Twenty-Two Autopsies

Abstract

300 cases of histologically proven sarcoidosis including 22 autopsies were reviewed from both the clinical and pathologic standpoints. Clinically this group of cases, largely from Army source material, showed a peak occurrence in the 20- to 24-yr. age group and an occurrence rate 17 times as high in the Negro as in the white male. Enlarged lymph nodes were by far the most common finding (86%) while cough, wt. loss, skin manifestations, low grade fever, malaise and weakness showed a 20 to 10% incidence in these cases. Mediastinal widening and small bone involvement were demonstrated by X-ray in 76 and 36%, respectively; tuberculin tests were negative in 97%; the sedimentation rate was elevated in 62%; and hyperproteinemia was present in 33%. In the 22 autopsied cases sarcoidosis was unsuspected until autopsy in nearly 2/3. The miliary granulomata of sarcoidosis demonstrated an evolution which resulted in healing by fibrosis. Giant cell inclusions occurred in 6% of the material, Schaumann bodies in 4% and spiculated bodies in 2%. Some degree of necrosis occurred in 35% of this material.