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Washington University Experience | PERIPHERAL NEUROPATHY | 9A SARCOID | 1H Case 1 Denouement
Denouement: ---- The finding of non-necrotizing granulomas has a broad differential, including: Wegener's granulomatosis, lymphomatoid granulomatosis, leprosy, Churg-Strauss angiitis, angioimmunoblastic lymphadenopathy, pure granulomatous neuropathy and sarcoidosis. The absence of microorganisms and involvement of both muscle and nerve is inconsistent with leprosy. Wegener's granulomatosis usually shows renal and/or pulmonary involvement. Lymphomatoid granulomatosis is a lymphoproliferative lesion which also usually shows pulmonary involvement and contains atypical lymphoid cells. Pure granulomatous neuropathy confined to nerve is excluded by the involvement of skeletal muscle. The diagnosis of sarcoidosis is one of exclusion and the histologic appearance of this nerve and muscle is consistent with that diagnosis.
