Objectives: To review retrospectively our experience with peripheral blood
eosinophilia (PBE) in sarcoidosis and to analyze histologically lung biopsy
specimens for the presence of lung tissue eosinophils.
Patients and Methods: We reviewed 140 cases of sarcoidosis diagnosed betwee
n May 1975 and January 1998, Ninety-five patients (66.3% women; 70.5% Afric
an American; mean age, 35.9 years) met the inclusion criteria. Transbronchi
al biopsy specimens from 82 patients mere divided into 4 morphologic compar
tments: parenchyma, bronchial wall, parenchymal granulomas, and bronchial w
all granulomas, Within compartments, up to 10 highpower fields were scored
semiquantitatively for eosinophils, from 0 (none) to 4+ (numerous).
Results: Thirty-nine patients (41%) had PBE. Four had PBE greater than 10%.
The highest eosinophil count (21%) occurred in 1 patient. Sixty-five (79%)
of 82 patients had no or few (1+) eosinophils in lung tissue; 17 patients
had eosinophils scored as 2+ or higher. There was no correlation between pe
ripheral blood eosinophil count and presence of eosinophils in transbronchi
al biopsy specimens, Eosinophils were least conspicuous in parenchyma but e
venly distributed in bronchial wall and parenchymal and bronchial wall gran
ulomas.
Conclusions: Peripheral blood eosinophilia occurs frequently in sarcoidosis
. However, there appears to be no association between peripheral blood eosi
nophil count and presence of lung tissue eosinophils, Whether eosinophils p
articipate in the pathogenesis of sarcoidosis requires further study.