Comments on Systemic Sarcoidosis

¹ The Department of Medicine, Jefferson Medical College and the Division of Medicine, Pennsylvania Hospital, Philadelphia, Pennsylvania.

Sarcoidosis is a disease of unknown cause. The basic morbid anatomy regardless of the organ or tissue involved is the epithelioid cell tubercle without necrosis, having refractile or calcified inclusion bodies in the giant cells.

Lesions are usually widely disseminated. The tissues most frequently involved are lymph nodes, lung, liver, spleen, skin, eyes and bones, particularly of the hands. The heart, striated muscles, stomach, intestines, kidneys, bladder, pituitary and thyroid glands, and central nerves may also be involved.

The clinical course is usually chronic with minimal or no constitutional symptoms; however, there may be acute episodes of fever and malaise with or without signs or symptoms referable to the tissues and organs involved.

The intracutaneous tuberculin test is usually negative; the plasma globulins are often increased.

The outcome may be clinical recovery with radiographic evidence of residue, or impairment of function of organs involved, or a continued chronic course of the disease. Treatment is unsatisfactory. Prognosis is uncertain.