Asteroid bodies in a lymph node aspirate. A case report.
BACKGROUND
Sarcoidosis, a multisystem disease with tbe potential to occur at any site, has varied clinical manifestations. Cutaneous lesions, seen in one-third of patients, may precede systemic manifestations. Identification of asteroid bodies in aspirated material may aid early diagnosis in the appropriate clinical setting.


METHODS
A 37-year-old woman had multiple asymptomatic, buff-colored, sucutaneous nodules, 0.5-1.0 cm in diameter, on the scalp, face, dorsum of the wrist and back of the elbows for 2 months. On examination, firm, nontender right inguinal and epitrochlear lymphadenopathy, 2 x 1 cm each, was detected. The epitrochlear lymph node aspirate showed noncaseating epithelioid granulomas, multinucleate giant cells and asteroid bodies. Subsequent biopsy of 1 of the subcutaneous nodules corroborated the aspiration cytology findings. Following the diagnosis of sarcoidosis, other investigations were done. Erythrocyte sedimentation rate was 66 mm at the end of 1 hour, Mantoux test was negative, and chest radiograph showed bilateral reticulonodular shadows. Angiotensin-converting enzyme level was significantly elevated.


CONCLUSIONS
This case draws attention to 1 of the rare cytologic findings of sarcoidosis. Differentiation from other granulomatous lesions, especially when special stains are negative, is difficult. In our case, a lymph node aspirate showing asteroid bodies in a background of granulomatous inflammation supported the diagnosis.
Rajasekharan
Preetha
P
Department of Pathology, KJ Somaiya Medical College & Research Centre, Sion, Mumbai, India. dr_pnair@yahoo.co.in
Narurkar
Swati
S
Patel
Keyuri
K
Rajpal
Aruna
A
D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D012507:Sarcoidosis / Q000175:diagnosis*; D012871:Skin Diseases / Q000175:diagnosis* / Q000473:pathology