Which of the following is not characteristically associated with sarcoidosis?

Sarcoidosis is a systemic granulomatous disease. origin- unknown Involve many different tissues and organs. It appears in many clinical patterns, but bilateral hilar lymphadenopathy is most common, occuring in 90% of cases Pathogenetic factors involved are: Immunologic Factors Intra-alveolar and interstitial accumulation of CD4+ T cells, resulting in CD4/CD8 T-cell ratios ranging from 5:1 to 15:1 Increased levels of cytokines - IL-2 and IFN-g Dendritic cell function is impaired. Genetic Factors Familial and racial clustering of cases and the association with HLA-1 and HLA-B8 Histologically, Nonnecrotizing granulomas - containing aggregates of tightly clustered epithelioid macrophages, often with giant cells It is unlikely to see central necrosis With chronicity the granulomas gets enclosed within fibrous rims or gets replaced by hyaline fibrous scars Laminated concretions composed of calcium and proteins known as Schaumann bodies and stellate inclusions known as asteroid bodies are found within giant cells. The lungs - most common sites of involvement. Other organs affected are: Lymph node Spleen Liver Bone marrow Skin Eye Muscle