Pulmonary vascular involvement in sarcoidosis : granulomatous angiitis and microangiopathy in transbronchial lung biopsies

To evaluate the occurrence of granulomatous angiitis and microangiopathy in the lung with sarcoidosis, transbronchial lung biopsy specimens were examined from 174 cases with sarcoidosis. Granulomatous angiitis was seen in 72 cases, which corresponded to 53% of the cases with granulomata. Granulomato...

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Published in:Virchows Archiv A Pathological Anatomy and Histopathology 1991-01, Vol.418 (4), p.361-368
Main Authors: TAKEMURA, T, MATSUI, Y, MIKAMI, R, ORITSU, M, AKIYAMA, O, HIRAGA, Y, OMICHI, M, HIRASAWA, M, SAIKI, S, TAMURA, S, MOCHIZUKI, I
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biopsy
Complement C3 - metabolism
Female
Humans
Immunoglobulin A - metabolism
Immunoglobulin G - metabolism
Immunoglobulin M - metabolism
Immunohistochemistry - methods
Lung - blood supply
Lung - pathology
Lung Diseases - metabolism
Lung Diseases - pathology
Lung Diseases - physiopathology
Male
Medical sciences
Microcirculation
Microscopy, Electron
Peptidyl-Dipeptidase A - blood
Sarcoidosis - metabolism
Sarcoidosis - pathology
Sarcoidosis - physiopathology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Vasculitis - metabolism
Vasculitis - pathology
Vasculitis - physiopathology
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Summary:To evaluate the occurrence of granulomatous angiitis and microangiopathy in the lung with sarcoidosis, transbronchial lung biopsy specimens were examined from 174 cases with sarcoidosis. Granulomatous angiitis was seen in 72 cases, which corresponded to 53% of the cases with granulomata. Granulomatous angiitis showed venous involvement (65%), both venous and arterial involvement (24%) or arterial involvement only (11%). There was no significant difference in occurrence of granulomatous angiitis between upper and lower lobes. The cases with granulomatous angiitis in the lung had a higher frequency of ophthalmic symptoms and elevated serum angiotensin converting enzyme level. Basal lamina layering in the microvasculature was more often observed in the bronchial mucosa than in the alveolar walls and is not exclusively related to granulomata. Endothelial proliferation and basal lamina alterations in granulomatous angiitis may be closely associated with granulomas. The present study revealed coexistence of granulomatous angiitis and microangiopathy in the lung with sarcoidosis and suggests that both may participate in the development of pulmonary sarcoidosis.
ISSN:0174-7398
1432-2307
DOI:10.1007/BF01600167