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March 1972

Whipple's Disease Simulating Sarcoidosis: A Case With Unique Clinical and Histologic Features

Author Affiliations

Rochester, Minn

From the Mayo Graduate School of Medicine, University of Minnesota (Drs. Rodarte and Garrison); and Department of Experimental and Anatomic Pathology (Dr. Holley), and Division; of Thoracic Diseases and Internal Medicine (Dr. Fontana), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Arch Intern Med. 1972;129(3):479-482. doi:10.1001/archinte.1972.00320030099012

Whipple's disease is a treatable condition capable of involving multiple organ systems. The gastrointestinal symptoms of this disease may be relatively inconspicuous. Specific histologic abnormalities can be detected with the standard light microscope. The most important of these is the presence of histiocytes that contain intracytoplasmic material in the form of minute sickleshaped particles, the so-called sickleform particle-containing cells (SPC); this material stains positive with PAS. It has been stated that SPC cells are always demonstrable in any tissue, either abdominal or extraabdominal, affected by the disease.1-3

We report a case of Whipple's disease in which antemortem study of grossly abnormal peripheral lymph nodes, lung, and pleura failed to disclose SPC cells, but showed changes suggestive of sarcoidosis. Consequently, the diagnosis of Whipple's disease was not given serious consideration. Microscopic examination of extra-abdominal tissues may substantiate a diagnosis of Whipple's disease but cannot exclude it.

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