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》

作者：

1. 上海交通大学医学院附属新华医院呼吸科(上海 200092);;
2. 上海交通大学医学院附属新华医院病理科(上海 200092);

关键词：

多系统结节病诊断治疗体层摄影术病理

DOI：

10.7507/1671-6205.2014044

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的提高对多系统结节病的认识及诊治水平,避免漏诊、误诊。方法结合相关文献复习对1例多系统结节病患者的诊治进行分析。结果患者表现为咳嗽、咳痰,临床症状无特异性。结节病最易侵犯肺及其他胸部脏器,胸部增强CT特点为双侧肺门淋巴结对称性增大,伴或不伴纵隔淋巴结增大,肿大淋巴结边界清楚,强化均匀,未见融合。PET/CT显像中肿大淋巴结多呈结节样、对称分布。支气管镜下可见支气管黏膜炎症和黏膜结节。结节病的确诊依靠病理学检查。典型的结节病病理表现为散在、紧密的非干酪样坏死性肉芽肿。激素治疗有效。结论结节病是一种病因不明的全身多系统疾病,缺乏特异性临床表征,因而容易误诊。影像学检查及相关实验室检查有助于结节病的诊断。确诊依靠病理检查。

引用本文： 张悦, 韩锋锋, 郭雪君, 管雯斌, 孙晋渊, 宋琳, 戈霞晖. 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, 2013, 12(2): 185-189. doi: 10.7507/1671-6205.2014044 复制

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1. Polychronopoulous VS,Prakash UB.Airway involvement in sarcoidosis.Chest,2009,136:1371-1380.
2. Clement DS,Postma G,Rothova A,et al.Intraocular sarcoidosis of clinical characteristics of uveitis with positive chest high-resolution computed tomography findings.Br J Ophthalmol,2010,94:219-222.
3. Costabel U,Ohshimoa S,Guzman J.Diagnosis of sarcoidosis.Curr Ooin Pulm Med,2008,14:455-461.
4. 邓文静,杨岚.结节病19例临床分析.中国呼吸与危重监护杂志,2012,11:176-179.
5. 关志伟,姚树林,王瑞民,等.22例结节病¹⁸F-FDG PET/CT影像学特征分析.中华核医学杂志,2011,31:334-338.
6. Kruger S,Buck AK,Mottaghy FM,et al.Use of integrated FDG PET/CT in sarcoidosis.Clinical Imaging,2008,32:269-273.
7. Malasamy S,Dala B,Bimenyuy C,et al.The clinical and radiologic features of nodular pulmonary sarcoidosis.AJR, 2009,187:9-15.
8. Michael CI,Benjamin AR,Alvin ST.Sarcoidosis.N Eng J Med,2007,357:2153-2165.
9. Boros PW,Enright PL,Quanjer PH,et al.Impaired lung compliance and DL,CO but no restrictive ventilatory defect in sarcoidosis.Eur Respir J,2010,36:1315-1322.
10. Danila E,Jurgauskiene L,Malickaite R.BAL fluid cells and pulmonary function in different radiographic stages of newly diagnosed sarcoidosis.Adv Med Sci,2008,53:228-233.
11. Gerke AK,Hunninghake G.The immunology of sarcoidosis.Clin Chest Med,2008,29:379-390.
12. 金儿,任振义,王利民.临床常用的几种检查方法在胸部结节病诊断和分期中的应用价值.医学研究杂志,2007,36:111-113.
13. Judson MA.The diagnosis of sarcoidosis.Clin Chest Med,2008,29:415-427.
14. Tremblay A,Stather DR,Maceachern P,et al.A randomized controlled trial of standard vs endobronchial ultrasonography-guided transbronchial needle aspiration in patients with suspected sarcoidosis.Chest,2009,136:340-346.
15. Nakajima T,Yasufuku K,Kurosu K,et al.The role of EBUS-TBNA for the diagnosis of sarcoidosis--comparisons with other bronchoscopic diagnostic modalities.Respir Med,2009,103:1796-1800.
16. Navani N,Booth HL,Kocjan G,et al.Combination of endobronchial ultrasound-guided transbronchial needle aspiration with standard bronchoscopic techniques for the diagnosis of stage I and stage II pulmonary sarcoidosis.Respirology,2011,16:467-472.

《中国呼吸与危重监护杂志》

多系统结节病误诊为淋巴瘤一例并文献分析

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《中国呼吸与危重监护杂志》

多系统结节病误诊为淋巴瘤一例并文献分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

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Format

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