Histopathology of Sarcoidosis and Its Immunological Bases

An autopsy case of sarcoidosis associated with intermittent fever and marked splenomegaly and 28 biopsy cases were studied on its histological changes according to the stage. Diffuse lymphoreticular histiocytosis was considered to precede typical granuloma formation, though it has not been mentioned in the literature. Hyalinizing fibrosis following epithelioid cell granuloma occurred fairly rapidly and frequently from the periphery of the tuberculoid granuloma and progressed towards the inside of the granuloma with only giant cells of the foreign body type remaining. The entity of this phenomenon has been referred to as localized immune mechanism or local hyperglobulinosis. The author recognized the evidence in a previous study that immune globulins, polyclonal in type, were concentrated in and around the granuloma. From the concept that some antigenic agent consists in the Kveim reagent, the direct method of fluorescent antibody technique was introduced and distinctive fluorescence suggestive of an antigenic agent was obtained. ACTA PATH. JAP. 20: 171 ‐ 182, 1970.