A 40-year-old non-smoker woman presents with bilateral hilar lymphadenopathy, erythema nodosum, and arthralgias. Lymph node biopsy shows non-necrotizing granulomas. Which finding, if present, would be most specific for sarcoidosis?
- A Asteroid bodies and Schaumann bodies within giant cells ✓
- B Caseous necrosis
- C Langhans giant cells
- D Epithelioid histiocytes
Correct answer: A. Asteroid bodies and Schaumann bodies within giant cells
Explanation
Sarcoidosis shows non-caseating granulomas (unlike TB which shows caseation). Asteroid bodies (star-shaped eosinophilic inclusions) and Schaumann bodies (laminated basophilic calcium concretions) within giant cells are characteristic though not pathognomonic. Epithelioid histiocytes and Langhans giant cells are seen in all granulomatous diseases. Caseation argues against sarcoidosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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