Pathology of Sarcoidosis and Differential Diagnostics of other Granulomatous Diseases

Granulomatous diseases are the heterogeneous group of the conditions of different etiologies with a variety of clinic syndromes and morphological features and nonuniform sensitivity to therapy, and the existence of granulomas as general dominate histological expression. Granuloma is indicative of chronic inflammation involving cells of the macrophage system and other inflammatory cells. After the antigen exposure, the activation of T-lymphocytes, macrophages, and epithelioid histiocytes leads to granuloma formation. Granuloma also contains the extracellular matrix produced by fibroblasts, which provide the boundary and isolation of antigen. Their etiology may classify granulomatous diseases as infectious and noninfectious. However, recent studies demonstrate that pathogenic microorganisms may cause the granuloma formation in diseases previously considered as noninfectious. In some cases, differentiation between infectious and noninfectious processes may be problematic. This chapter aims to highlight the multiformity of granulomatous diseases, characterize the pathologic features of different infectious and noninfectious granulomatosis, and delineate the diagnostic approach.