CLINICAL, MORPHOLOGICAL AND MORPHOMETRIC ASSESSMENT OF GRANULOMATOUS INFLAMMATION IN SARCOIDOSIS AND PULMONARY TUBERCULOSIS
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.
Raikhan Zh. Nygyzbayeva1, http://orcid.org/0000-0001-6264-1872
Maria А. Svetkina1, https://orcid.org/0009-0003-3655-1269
Leila M. Stabayeva1*, https://orcid.org/0000-0001-8598-1829
Maida M. Tussupbekova1, https://orcid.org/0000-0003-3105-4450
Gulnazira N. Imanbayeva1, http://orcid.org/0000-0002-9091-4601
Sabina S. Abieva1, http://orcid.org/0000-0001-7811-5367
1 «Karaganda Medical University» NCJSC, Department of Pathology,
Karaganda, Republic of Kazakhstan.
1. Ariel' B.M., Dvorkovskaya I.V., Zil'ber E.K., Maiskaya M.Yu., Koval'skii G.B. [i dr.] O nekotorykh eshche ne ispol'zovannykh vozmozhnostyakh differentsial'noi diagnostiki sarkoidoza i tuberkuleza [On some unused possibilities of differential diagnostics of sarcoidosis and tuberculosis]. Pul'monologiya [Pulmonology]. 2016. 26(3). pp.309-315. https://doi.org/10.18093/0869-0189-2016-26-3-309-315 [in Russian]
2. Belokurov M.A., Starshinova A.A., Zhuravlev V.Yu. Immunologicheskie metody v differentsial'noi diagnostike tuberkuleza i sarkoidoza organov dykhaniya [Immunological methods in differential diagnostics of tuberculosis and sarcoidosis of respiratory organs]. Meditsinskaya immunologiy [Medical Immunology]. 2015. V.7(2), pp.98-104. https://doi.org/10.22625/2072-6732-2015-7-2-98-104 [in Russian]
3. Dvorakovskaya I.V. i dr. Morfologicheskoe issledovanie v differentsial'noi diagnostike tuberkuleza i sarkoidoza [Morphological study in differential diagnostics of tuberculosis and sarcoidosis.]. Arkhivy patologii [Archives of pathology]. 2014. T. 76, № 1. pp. 27–31. [in Russian]
4. Kozyrev O.A. [i dr.] Trudnosti diagnostiki sarkoidoza v terapevticheskoi praktike [Difficulties in diagnosing sarcoidosis in therapeutic practice]. Vestnik SurGU. Meditsina [Bulletin of Surgut State University. Medicine]. 2018. № 2 (36). pp. 44-46. [in Russian]
5. Tussupbekova M.M. [i dr.] Morfologicheskaya verifikatsiya sarkoidoza s drugimi granulematoznymi porazheniyami legkikh [Morphological verification of sarcoidosis with other granulomatous lung lesions]. Med. Novosti [Med. news]. 2016. № 9 (264). pp. 60-62. [in Russian]
6. Tsinzerling V. A. [i dr.] Prblemy morfologicheskoi diagnostiki tuberkuleza [Problems of morphological diagnostics of tuberculosis]. Arkhivy patologii [Archives of pathology]. 2015. №3. pp.3–9. DOI: 10.17116/patol-2015-77-3-3-9 [in Russian]
7. Tsinzerling A.V. [i dr.] K voprosu ob etiologii makrofagal'nykh granulem v organakh dykhaniya i limfaticheskikh uzlakh: nablyudeniya iz praktiki [On the etiology of macrophage granulomas in the respiratory organs and lymph nodes: observations from practice]. Zhurnal infektologii [Journal of Infectology]. 2013. № 3. pp. 67-70. [in Russian]
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Nygyzbayeva R.Zh., Svetkina M.A., Stabayeva L.M., Tussupbekova M.M., Imanbayeva G.N., Abieva S.S., Abramova G.D. Clinical, morphological and morphometric assessment of granulomatous inflammation in sarcoidosis and pulmonary tuberculosis // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (6), pp. 72-80. doi 10.34689/SH.2024.26.6.009Related publications:
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