Drury R A
Postgrad Med J. 1970 Aug;46(538):478-83. doi: 10.1136/pgmj.46.538.478.
The sarcoid granuloma has a histological structure that is similar to that seen in many other diseases. Some of its diagnostic features are negative, but an accurate diagnosis can be made from biopsy tissues if numerous, monotonously uniform granulomata are present. Histological confidence is often proportional to the number of granulomata seen in the specimen. Mediastinal lymph nodes taken at mediastinoscopy have been positive in 90% of seventy-four patients with sarcoidosis. Problems in the histological interpretation of Kveim biopsies may be due to failure to include the injection site in the biopsy, to inadequate sectioning of the specimen and to equivocal cellular reactions. Despite these difficulties, dual blind reading of sections of mediastinal lymph nodes and Kveim reaction biopsies from patients with sarcoidosis has shown that the observer variation that is likely to be of clinical significance is approximately 5% in each group.
结节病肉芽肿具有一种组织学结构，该结构与许多其他疾病中所见的结构相似。其一些诊断特征为阴性，但如果存在大量单调均匀的肉芽肿，则可通过活检组织做出准确诊断。组织学诊断的可信度通常与标本中所见肉芽肿的数量成正比。在74例结节病患者中，经纵隔镜检查获取的纵隔淋巴结有90%呈阳性。Kveim活检组织学解读中的问题可能是由于活检时未包括注射部位、标本切片不足以及细胞反应不明确所致。尽管存在这些困难，但对结节病患者的纵隔淋巴结切片和Kveim反应活检进行双盲阅读显示，每组中可能具有临床意义的观察者差异约为5%。
