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Open AccessArticle

Sarcoid-Like Granulomatous Disease: Pathologic Case Series in World Trade Center Dust Exposed Rescue and Recovery Workers

1
Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA
2
Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
3
School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
*
Author to whom correspondence should be addressed.
The authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2019, 16(5), 815; https://doi.org/10.3390/ijerph16050815
Received: 23 January 2019 / Revised: 22 February 2019 / Accepted: 26 February 2019 / Published: 6 March 2019
(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)
Sarcoid-like granulomatous diseases (SGD) have been previously identified in cohorts of World Trade Center (WTC) dust-exposed individuals. In the present studies, we analyzed lung and/or lymph node biopsies from patients referred to our clinic with suspected WTC dust-induced lung disease to evaluate potential pathophysiologic mechanisms. Histologic sections of lung and/or lymph node samples were analyzed for markers of injury, oxidative stress, inflammation, fibrosis, and epigenetic modifications. Out of seven patients examined, we diagnosed four with SGD and two with pulmonary fibrosis; one was diagnosed later with SGD at another medical facility. Patients with SGD were predominantly white, obese men, who were less than 50 years old and never smoked. Cytochrome b5, cytokeratin 17, heme oxygenase-1, lipocalin-2, inducible nitric oxide synthase, cyclooxygenase 2, tumor necrosis factor α, ADP-ribosylation factor-like GTPase 11, mannose receptor-1, galectin-3, transforming growth factor β, histone-3 and methylated histone-3 were identified in lung and lymph nodes at varying levels in all samples examined. Three of the biopsy samples with granulomas displayed peri-granulomatous fibrosis. These findings are important and suggest the potential of WTC dust-induced fibrotic sarcoid. It is likely that patient demographics and/or genetic factors influence the response to WTC dust injury and that these contribute to different pathological outcomes. View Full-Text
Keywords: WTC; fibrotic sarcoid; injury; inflammation; fibrosis WTC; fibrotic sarcoid; injury; inflammation; fibrosis
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Sunil, V.R.; Radbel, J.; Hussain, S.; Vayas, K.N.; Cervelli, J.; Deen, M.; Kipen, H.; Udasin, I.; Laumbach, R.; Sunderram, J.; Laskin, J.D.; Laskin, D.L. Sarcoid-Like Granulomatous Disease: Pathologic Case Series in World Trade Center Dust Exposed Rescue and Recovery Workers. Int. J. Environ. Res. Public Health 2019, 16, 815.

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