Makarova O V, Mikhaĭlova L P, Goncharova E V, Borisov S E
Institute of Human Morphology, 117418, Moscow.
Arkh Patol. 2001 Jan-Feb;63(1):6-11.
Comparisons are given of clinical manifestations and pathomorphological changes in lymph nodes and lungs of 76 patients with sarcoidosis and 48 patients with tuberculosis. Two types of tissue reactions were shown: with minimal and marked fibrosis. The former type is characterized by high density of granulomatosis and low density of fibrosis, large granulomas which contained many giant cells. The latter type is characterized by advanced fibrosis, small granulomas with rare giant cells. For clinically marked sarcoidosis, tissue reaction with predominant granulomatosis is typical, for patients with scare symptoms--tissue reaction with evident fibrosis. In the absence of caseous necrosis, differential diagnosis between tuberculosis and sarcoidosis with prevalent granulomatosis is impossible by morphological picture and morphometric evidence.
对76例结节病患者和48例结核病患者的淋巴结及肺部的临床表现和病理形态学变化进行了比较。结果显示出两种组织反应类型：轻度纤维化和显著纤维化。前一种类型的特点是肉芽肿密度高、纤维化密度低，有许多巨细胞的大肉芽肿。后一种类型的特点是纤维化进展、巨细胞少见的小肉芽肿。对于临床症状明显的结节病，以肉芽肿为主的组织反应是典型的，对于症状轻微的患者，则是明显纤维化的组织反应。在无干酪样坏死的情况下，根据形态学图像和形态计量学证据，无法对结核病和以肉芽肿为主的结节病进行鉴别诊断。
