History: These images are from a fine needle aspiration biopsy of a lymph node in a patient with lymphadenopathy, joint symptoms, and elevated ACE. What is your diagnosis?
Answer: Well-formed granuloma characteristic of sarcoidosis.
Comment: This air-dried smear demonstrates well-formed granulomata. The histiocyte nuclei are elongated with a shape reminiscent of a footprint. Their arrangement in granulomata have been described as being like a “dance step diagram.”
This case was provided by Dr. Xiaoyin “Sara” Jiang, MD, Associate Professor of Pathology at Duke University and Director of the Head and Neck Service. The book Survival Guide to Cytopathology that she and Dr. Wen-Chi Foo wrote is now being reviewed and should be released in the Summer. You can preorder your copy at: