About unimproved opportunities of differentiation of sarcoidosis and tuberculosis

This study was aimed at analysis of own experience of differentiation between pulmonary tuberculosis and sarcoidosis. Methods.We evaluated VATS biopsy samples from 250 patients with disseminated lesion of the lungs and/or intrathoracic lymph nodes of unknown origin. Previous examination excluded any known granulomatosis excepting pulmonary tuberculosis and sarcoidosis. The biopsy samples were collected in different regions of Russia in 2010–2014. Results.Typical epithelioid cell granulomas with giant multinucleated cells were seen in lymph nodes and the lung tissue in all cases. Necrosis and/or presence of acid"fast mycobacteria were necessary and sufficient sign of tuberculosis. Granulomas without necrosis and mycobacteria in slice series, but not in one or two incident slices, were considered as highly specific for sarcoidosis. Conclusion.We suppose that differentiation between tuberculosis and sarcoidosis should be based on complex clinical and morphological analysis with the determinant role of morphological examination