A skin biopsy of an indurated plaque shows well-formed epithelioid cell granulomas with sparse surrounding lymphocytes and no central caseation. Inclusions described as star-shaped structures within giant cells are identified. What are these inclusions called?

• A Asteroid bodies ✓
• B Schaumann bodies
• C Civatte bodies
• D Michaelis-Gutmann bodies

Explanation

Sarcoidosis produces naked, noncaseating epithelioid granulomas, so named because of the thin rim of lymphocytes around them. Asteroid bodies are stellate cytoplasmic inclusions within multinucleate giant cells, classically described in sarcoidosis though not pathognomonic. Schaumann bodies are concentric lamellated calcified concretions, Civatte bodies are apoptotic keratinocytes of lichenoid dermatitis, and Michaelis-Gutmann bodies indicate malakoplakia.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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