Unraveling Granulomatous and Histiocytic Disorders: A Multi-Organ Histological Spectrum
Dr. Sathakathulla Almas Zareen
Keywords: Granulomatous disorders, Histiocytic disorders, Fibrin-ring granuloma, Rosai–Dorfman disease, Langerhans cell histiocytosis
Introduction: Granulomatous and histiocytic disorders are a heterogeneous group of conditions that may involve multiple organ systems and often mimic infections, autoimmune diseases, or malignancies. Accurate recognition is essential, as misdiagnosis may result in inappropriate management.
This study presents a multi-organ spectrum of such disorders identified in lymph node, spleen, skin, kidney, liver, and bone biopsies. Cases included tuberculous lymphadenitis, cutaneous sarcoidosis, leprosy of the skin, Kikuchi–Fujimoto disease, Rosai–Dorfman disease, chronic xanthogranulomatous pyelonephritis, Q fever hepatitis with fibrin-ring granulomas, and Langerhans cell histiocytosis of the skull. On hematoxylin and eosin staining, each entity demonstrated distinctive features: caseating epithelioid granulomas in tuberculosis, compact non-caseating granulomas in sarcoidosis, foamy histiocytes with perineural involvement in leprosy, paracortical necrosis with karyorrhectic debris in Kikuchi disease, emperipolesis in Rosai–Dorfman disease, foamy histiocytes in xanthogranulomatous pyelonephritis, fibrin-ring granulomas in Q fever, and grooved nuclei of Langerhans cells in histiocytosis.
Although some overlap exists, systematic evaluation of granuloma architecture, cytological features, and background changes, along with clinical correlation and ancillary techniques, enables accurate diagnosis. Recognition of these uncommon lesions is particularly important to differentiate them from lymphomas and other neoplastic conditions.
This spectrum underscores the central role of histopathology in diagnosing granulomatous and histiocytic disorders and highlights the value of a pattern-based approach in resolving challenging differentials.
References: [1] Kumar V., Abbas A. K. and Aster J. C. (2021) Robbins and Cotran Pathologic Basis of Disease, 10th ed., Elsevier.
[2] Dey B., Dutta V. and Sharma S. (2020) J Lab Physicians, 12, 52–57.
[3] Perry A. M. and Choi S. M. (2018) Arch Pathol Lab Med, 142, 1341–1346.
[4] Dalia S., Sagatys E., Sokol L. and Kubal T. (2014) Cancer Control, 21, 322–327.
[5] Kuo T. T. (1995) Pathology International, 45, 374–382.
[6] James D. G. and Sharma O. P. (1996) Histopathology, 28, 469–488.
[7] Parsons M. A., Harris M. and Longstaff A. J. (1983) Histopathology, 7, 725–737.
[8] Raoult D., Houpikian P., Tissot-Dupont H., Riss J. M., Arditi-Djiane J. and Brouqui P. (1999) Am J Pathol, 155, 623–629.
[9] Allen C. E., Li L., Peters T. L., Leung H. C., Yu A., Man T. K. et al. (2010) J Immunol, 184, 4557–4567.
Biography: Dr. Sathakathulla Almas Zareen completed her postgraduate training in Pathology at Tagore Medical College and Hospital, Chennai, where she is currently working as a Senior Resident. Her primary interest is histopathology with ongoing research in breast pathology titled “Immunohistochemical Detection of Myoepithelial Cells to Distinguish Benign from Malignant Breast Disease.” She is also pursuing work in dermatopathology through her study “Decoding the Skin: Clinical and Histopathological Spectrum of Dermatological Lesions.” Her extended areas of interest include hematopathology, cytopathology, oncopathology, and renal pathology.
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