PURPOSE: To identify and morphologically classify Polarizing Particulate Matter (PPM) present in granulomatous and non granulomatous tissue of sarcoidosis patients.
METHODS: Slides of biopsy specimens from 54 sarcoidosis patients referred to our outpatient practice were analyzed by light microscopy and then by polarizing light microscopy (Olympus BH-2 microscope) for PPM. A total of 87 images of specimens were recorded using a Polaroid camera (DMC-2 version 126.96.36.199.4). Images demonstrating PPM under polarizing microscopy were identified and PPM classified according to their morphological shapes. Biopsy reports of the specimens were then reviewed for presence or absence of granulomas.
RESULTS: Of 87 images reviewed, 41(47%) images were found to contain PPM and 46(53%) did not contain PPM. Of the 41 images found to contain PPM, granuloma were reported in 33(80%) biopsy specimens while no granuloma were reported in 8(20%). Three morphological shapes of PPM were classified: ovoid, cylindrical and irregular. 19(46%) were ovoid, 8(20%) were cylindrical and 14(34%) were irregular in shape. In specimens with granuloma, ovoid, cylindrical and irregular shapes were classified in 17, 4 and 12 images respectively. In specimens with no granuloma, ovoid, cylindrical and irregular shapes were classified in 2, 4, 2 images respectively. Of the 46 images that did not contain PPM, granuloma were reported in 34(74%) biopsy specimens while no granuloma were reported in 12(26%).
CONCLUSION: PPM was present in 41(47%) of 87 images. PPM were morphologically classified as ovoid (46%), cylindrical (20%) and irregular (34%) in shape.
CLINICAL IMPLICATIONS: The classification of PPM into various morphological shapes offers a new criterion to investigate characteristics of sarcoidosis patients. Future investigations using Raman spectroscopy for elucidating the chemical composition of these shapes of PPM are planned. The composition will enable us to develop in-vitro tests to identify patients sensitive to chemicals which may be involved in the etiology of sarcoidosis.
DISCLOSURE: Priya Bakaya, No Financial Disclosure Information; No Product/Research Disclosure Information