42例结节病临床特征分析  

Analysis on 42 Cases of Intrathoracic Sarcoidosis

作　　者：刘永虎 张静瑜 李艳[2] 白少军[3] 陈娟[1] 马爱玲[3] LIU Yonghu;ZHANG Jingyu;LI Yan;BAI Shaojun;CHEN Juan;MA Ailing(Department of Respiratory and Critical Care Medicine,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;Ningxia Medical Uuniversity,Yinchuan 750004,China;Department of Pathology,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院呼吸与危重症医学科,银川750004 [2]宁夏医科大学,银川750004 [3]宁夏医科大学总医院病理科,银川750004

出　　处：《宁夏医科大学学报》2020年第5期525-527,共3页Journal of Ningxia Medical University

摘　　要：目的分析结节病临床特征,以减少误诊。方法对组织病理确诊为结节病的42例患者临床资料进行回顾性分析。结果42例结节病患者中累及肺内39例(92.9%),胸膜18例(42.9%),气道20例(47.6%),其中气道黏膜累及出现气道膜充血4例(9.5%)、气道黏膜水肿7例(16.7%)、气道黏膜颗粒/结节9例(21.4%),胸内淋巴结累及42例(100.0%),其中上纵隔淋巴结肿大42例(100.0%)、下纵隔淋巴结肿大30例(71.4%)、主动脉淋巴结肿大30例(71.4%)、肺门淋巴结肿大27例(64.3%),外周淋巴结累及20例(47.6%)、皮肤6例(14.3%)、骨2例(4.8%)、脾脏、胰腺、腮腺各1例(2.4%)。42例均经淋巴结、皮下结节活检,或气管镜、纵隔镜、开胸活检确诊为结节病,其中26.0%被误诊为肺结核、肿瘤或其他疾病。结论结节病是一种多系统累及性疾病,临床高度怀疑结节病时需行活检,病理诊断需要排除增殖性结核病及其他非干酪样肉芽肿性疾病后方可诊断。Objective To improve the understanding of clinical characteristics of sarcoidosis and reduce misdiagnosis.Methods The clinical data of 42 patients with sarcoidosis confirmed by histopathology were analyzed retrospectively.Results Among 42 patients with sarcoidosis,39(92.9%)were involved in the lung,18(42.9%)in the pleura,20(47.6%)in the airway.Among them,4(9.5%)were involved in the airway mucous membrane,7(16.7%)were involved in the airway mucous membrane,9(21.4%)were involved in the airway mucous membrane,42(100.0%)were involved in the intrathoracic lymph nodes,42(100.0%)were involved in the upper mediastinal lymph nodes cases,lower mediastinal lymph nodes(71.4%),aortic lymph nodes(71.4%),hilar lymph nodes(64.3%),peripheral lymph nodes(47.6%),skin(14.3%),bone(4.8%),spleen,pancreas and parotid gland(2.4%).42 cases were diagnosed as sarcoidosis by lymph node biopsy,subcutaneous nodule biopsy,or tracheoscopy,mediastinoscopy,thoracotomy biopsy,of which 26.0%were misdiagnosed as tuberculosis,tumor,lymphoma or other diseases in the outside hospital.Conclusion Sarcoidosis is a disease that involves multiple systems.When it is highly suspected that sarcoidosis,biopsy should be performed.The diagnosis of proliferative tuberculosis and other non caseous granulomatous diseases should be excluded for pathological diagnosis.

关 键 词：结节病 结核病 病理 临床特征 

分 类 号：R56[医药卫生—呼吸系统]