Subsequent bronchoscopy with transbronchial biopsy showed multinucleated giant cells associated with laminated concentric calcification (Schaumann bodies
Giant cells and granulomas or Schaumann bodies
(which are markers of previous granulomas) are very helpful if found (Figures 3 and 4, B), but the reported proportion of cases with those features varies widely.
A variety of inclusions can be found within the cytoplasm of the giant cells including the stellate asteroid bodies and concentric calcifications known as schaumann bodies
. Though neither inclusion is pathognomonic for sarcoidosis, their presence can be helpful in suggesting the condition.
Additionally, asteroid and Schaumann bodies
may be seen within the giant cells.
which contain calcium oxalate crystals are found in 48% to 88% of the patients.
Several large, multinucleated Langhans-type giant cells were present (figure 2), some showing pink, intracytoplasmic asteroid bodies (figure 3, A) and Schaumann bodies
(figure 3, B).
(30) Cholesterol clefts (31) and Schaumann bodies
(nonspecific findings) are occasionally seen in association with the poorly formed granulomas, but necrosis is absent.
Patients with sarcoidosis may also exhibit asteroid bodies (stellate crystalline inclusions in multinucleated giant cells) (figure, B), Schaumann bodies
(calcified laminated concretions within multinucleated giant cells), and occasionally Hamazaki-Wesenberg bodies (coccoid, golden-brown, acid-fast cytoplasmic inclusions).
are ovoid concentric calcifications reportedly found in 70% to 88% of sarcoidosis cases, whereas asteroid bodies are stellate inclusions within cytoplasmic halos that are found in up to 9% of cases.
Isolated giant cells were confined to peribronchiolar interstitium; many of the giant cells contained calcified cytoplasmic Schaumann bodies
(Figures 8 and 9).
The giant cells may contain cytoplasmic inclusions, particularly Schaumann bodies
or asteroid bodies (Figures 6 and 4, respectively).
Fibrous tissue is less abundant than in granulomas at other sites. Schaumann bodies
and asteroid bodies may be identified.