{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:04:27Z","timestamp":1790705067442,"version":"4.1.0"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Sarcoidosis is a rare disease of isolated or diffuse granulomatous inflammation. Although any organs can be affected by sarcoidosis, cardiac sarcoidosis is a fatal disorder, and it is crucial to accurately diagnose it to prevent sudden death due to dysrhythmia. Although endomyocardial biopsy is invasive and has limited sensitivity for identifying granulomas, it is the only modality that yields a definitive diagnosis of cardiac sarcoidosis. It is imperative to develop novel pathological approaches for the precise diagnosis of cardiac sarcoidosis. Here, we aimed to discuss commonly used diagnostic criteria for cardiac sarcoidosis and to summarize useful and novel histopathologic criteria of cardiac sarcoidosis. While classical histologic observations including noncaseating granulomas and multinucleated giant cells (typically Langhans type) are the most important findings, others such as microgranulomas, CD68+ CD163\u2212 pro-inflammatory (M1) macrophage accumulation, CD4\/CD8 T-cell ratio, Cutibacterium acnes components, lymphangiogenesis, confluent fibrosis, and fatty infiltration may help to improve the sensitivity of endomyocardial biopsy for detecting cardiac sarcoidosis. These novel histologic findings are based on the pathology of cardiac sarcoidosis. We also discussed the principal histologic differential diagnoses of cardiac sarcoidosis, such as tuberculosis myocarditis, fungal myocarditis, giant cell myocarditis, and dilated cardiomyopathy.<\/jats:p>","DOI":"10.3390\/jcm11010251","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T01:14:02Z","timestamp":1641518042000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Histology of Cardiac Sarcoidosis with Novel Considerations Arranged upon a Pathologic Basis"],"prefix":"10.3390","volume":"11","author":[{"given":"Shu","family":"Kato","sequence":"first","affiliation":[{"name":"Postgraduate Clinical Training Center, Fujita Health University Hospital, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-9249","authenticated-orcid":false,"given":"Yasuhiro","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asako","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Kansai Medical University Hospital, Osaka 573-1191, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Pathology, Fujita Health University Bantane Hospital, Aichi 454-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Fujita Health University School of Medicine, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Shiogama","sequence":"additional","affiliation":[{"name":"Department of Morphology and Pathological Diagnosis, Fujita Health University School of Medical Sciences, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Morphology and Pathological Diagnosis, Fujita Health University School of Medical Sciences, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin\u2019ichiro","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fujita Health University School of Medicine, Aichi 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1016\/j.jacc.2020.08.042","article-title":"Challenges in cardiac and pulmonary sarcoidosis: JACC State-of-the-Art review","volume":"76","author":"Trivieri","year":"2020","journal-title":"J. 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