CLINICAL, MORPHOLOGICAL AND MORPHOMETRIC ASSESSMENT OF GRANULOMATOUS INFLAMMATION IN SARCOIDOSIS AND PULMONARY TUBERCULOSIS

Abstract

Relevance: Sarcoidosis and pulmonary tuberculosis are part of a heterogeneous group of granulomatous diseases, 
which unites over 70 diseases of various etiologies, characterized by the appearance of a cellular infiltrate in tissues – 
granulomas. Within the framework of one nosological form, for example, in sarcoidosis, the severity of clinical symptoms, the 
prevalence of the process, changes in laboratory, including immunological, indicators can be very diverse, which indicates 
their heterogeneity. The characteristic morphological signs corresponding to the initial stages of both sarcoidosis and 
pulmonary tuberculosis have not yet been established. 
Aim – determination of criteria for granulomatous inflammation in sarcoidosis and pulmonary tuberculosis for clinical, 
morphological and morphometric assessment of these pathologies. 
Materials and methods: In 2019-2024, a retrospective analysis of 89 archival materials of patients with diagnosed sarcoidosis 
(27) and disseminated pulmonary tuberculosis (62) was carried out using a comprehensive computerized device "Leica DM 1000" 
to study the clinical, morphological and morphometric picture of lung tissue in these diseases in order to identify verification criteria. 
Results: The study of archival material revealed clinical and morphological (in sarcoidosis - the formation of granulomas 
along the bronchovascular bundle, the presence of vasculitis, the presence of calcified Schauman bodies, etc., in 
tuberculosis - caseous necrosis and zoning of the granuloma structure), morphometric (in sarcoidosis - an increase in the 
number of plasma cells, lymphocytes, the number of granulocytes and epithelioid cells decrease, the number of structural 
elements of the stroma and destruction of interstitial tissue increases, the number of vessels increases, in tuberculosis - an 
increase in the number of granulocytes and epithelioid cells, respectively, giant multinucleated cells, the presence of caseous 
necrosis), the presence of which makes it possible to reliably differentiate these diseases. 
Conclusion: Morphological verification of the clinical diagnosis with the substantiation of the pathomorphological 
conclusion, which will allow determining the appropriate tactics of examination, administration and treatment of the patient, 
taking into account the revealed clinical and laboratory data, the results of instrumental research methods.