Differential diagnosis of sarcoidosis and tuberculosis from pathologist’s aspect

摘要

Introduction. Diagnosis of tuberculous and sarcoid granulomas is frequent in routine pathological practice. Tuberculosis and sarcoidosis have lately been considered to be the same disease but with different manifestations or two different diseases with the same manifestations because of the presence of the same antigens that stimulate formation of granulomas. That is why the differential diagnosis of sarcoidosis and tuberculosis could be difficult on biopsies. The aim of this study was to point to the difficulties met by a pathologist in diagnosing tuberculosis and sarcoidosis. Results. In case of typical morphology, the differentiation of sarcoidosis and tuberculosis is simple. In the presence of productive granulomas in tuberculosis or necrotizing granulomas in sarcoidosis, it is difficult to establish the pathological diagnosis without clinical data. The role of the pathologist in diagnosing sarcoidosis and tuberculosis is to establish the presence of granulomas and to suggest the diagnosis according to its morphology. The definitive diagnosis requires a multidisciplinary approach of pulmonologists, radiologists, microbiologists, immunologists, biochemists and pathologists. [Projekat Ministarstva nauke Republike Srbije, br. III41031]