[5] Sarcoidosis: Epidemiologic Profile and Autopsy Findings of 22 Cases.

Nella C Fernandez, Roger Smith, Fred Lucas, Qihui J Zhai. University of Cincinnati, OH; Greater Cincinnati Pathologists, Inc, OH

Background: Sarcoidosis, a multisystem disorder of unknown cause affecting young and middle-aged adults, often presents with bilateral hilar lymphadenopathy, pulmonary infiltration, ocular and skin lesions. Other organs may also be involved. The diagnosis is one of exclusion, established when clinicoradiological findings are supported by histological evidence of noncaseating epitheloid cell granulomas. We analyzed the clinical records and autopsy reports of patients seen at a teaching hospital to develop a epidemiologic profile of our population.
Design: 1106 consecutive autopsy cases from January 1st 1999 to July 31st 2010 were reviewed, and decedents with antemortem or postmortem diagnosis of sarcoidosis were included in the cohort. Patients were classified by gender, age, autopsy findings and concomitant conditions.
Results: The male: female ratio was 1:1.The mean age at the time of death was 49.09 years for males and 47.72 years for females. 18 patients were African-American and 4 were Caucasian. Diagnosis of sarcoidosis was antemortem in 13 cases and postmortem in 9. 2 of the cases did not have histological evidence of sarcoidosis on autopsy. The organs involved by the disease in the remaining 20 cases are listed in table 1.

Organs involved by sarcoidosis
OrganNumber of cases
Lungs15 / 20
Lymph nodes12 / 20
Heart8 / 20
Liver7 / 20
Bone marrow4 / 20
Spleen3 / 20
Kidney2 / 20
Gastrointestinal tract1 / 20
Central nervous system1 / 20
Pancreas1 / 20


Medical history was available for 21 of the 22 cases and concomitant conditions are listed in table 2.

Concomitant conditions
DiagnosisCases
Hypertension14 / 21
Diabetes11 / 21
Asthma8 / 21
Kidney disease8 / 21
Liver disease4 / 21


10 patients had hypertension and diabetes and 5 patients had hypertension, diabetes and asthma. Sarcoidosis was the main contributor to death in 9 cases. Cardiac sarcoidosis was present in 5 of those.
Conclusions: Race and gender distribution of this cohort is similar to that reported in the literature, with predominance of African American and 1:1 male:female ratio. Airway hypereactivity is reported in up to 20% of sarcoidosis cases. In our series it was present in 40% .Cardiac sarcoidosis is a rare manifestation, symptomatic in 5% of patients. In our series there was myocardial involvement in 40% of cases and accounted for 55% of deaths directly caused by sarcoidosis. This observation underscores the importance of appropiate sampling of the heart to avoid failure to report this finding.
Category: Autopsy

Monday, February 28, 2011 2:00 PM

Platform Session: Section G, Monday Afternoon

 

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