目的
探讨结节病的临床特点和诊断方法。
方法
回顾性分析我院2012年4月至2015年9月经病理学确诊的4例结节病患者的临床及影像学资料。
结果
4例结节病患者中,男3例, 女1例,年龄23~70岁。3例患者临床表现为咳嗽、胸闷和气促,其中1例以腮腺肿大为主要表现;另1例无明显临床症状。胸部CT均显示肺门及纵隔淋巴结肿大。患者均经淋巴活检、腮腺外科活检。给予糖皮质激素治疗效果良好。
结论
结节病较少见,临床表现无特异性,临床易误诊。对肺门及纵隔淋巴结肿大病例,应尽早行病理学检查以明确诊断。结节病治疗首选糖皮质激素。
Citation:
丁雁启, 李合友, 袁雪芹. 结节病四例诊治体会. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(2): 176-178. doi: 10.7507/1671-6205.2016025041
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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- 1. 张悦, 韩锋锋, 郭雪君, 等.多系统结节病误诊为淋巴瘤一例并文献分析.中国呼吸与危重监护杂志, 2014, 13: 185-189.
- 2. 徐作军.结节病.实用诊断与治疗杂志, 2006, 20: 161-164.
- 3. Boeck C.Multiple benign hud-sarkoid.Norsck Laegevidensk, 1899, 60:1321.
- 4. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med, 2007, 357:2153-2165.
- 5. Sharma N, Tariq H, Uday K, et al.Hypercalcemia, anemia, and acute kidney injury: a rare presentation of sarcoidosis. Case Rep Med, 2015, 2015: 565243.
- 6. Little BP. Sarcoidosis: overview of pulmonary manifestations and imaging. Semin Roentgenol, 2015, 50:52-64.
- 7. 张春阳, 张新红, 冯华松, 等. 肺结节病合并胸腔积液14例诊治分析.临床肺科杂志, 2010, 16: 1531-1532.
- 8. 王峰, 童朝晖, 王臻, 等.结节病胸膜病变合并胸前积液六例报告及文献复习.中华结核和呼吸杂志, 2015, 38: 99-104.
- 9. ATS/ERS/WASOG.Committee: Statement on sarcoidosis. Am J Respir Crit Care Med, 1999, 160: 736-755.
- 10. 张立群, 刘振千, 吴晓光, 等. 结节病诊断的研究进展. 中国临床医生, 2011, 39: 19-22.
- 11. Mandal SK, Ghosh S, Mondal SS, et al. Coexistence of pulmonary tuberculosis and sarcoidosis: a diagnostic dilemma. BMJ Case Rep, 2014, 2014. pii: bcr2014206016.