结节病

A case of sarcoidosis and literature review

目的:分析1例以皮损为首发表现,同时累及呼吸系统的结节病的临床及影像学特征,提高本病诊治水平,减少误诊。方法:分析患者临床资料、辅助检查及诊治过程,并结合文献进行回顾性分析。结果:女性患者,34岁。因皮疹4个月,胸闷2周而入院。皮损组织病理发现非干酪样肉芽肿浸润,经胸部CT、支气管镜等检查除外结核、真菌等微生物感染及肿瘤后,确诊为结节病。给予糖皮质激素治疗,效果满意。结论:皮肤结节病发病隐匿,常出现误诊,确诊需依赖组织活检及影像学检查,治疗以糖皮质激素为首选,但给药前需除外结核、真菌感染及肿瘤等疾病。

Objective： To improve the diagnosis and treatment of sarcoidosis, the clinical and imaging features were analyzed in a case of sareoidosis with skin lesion as the first presentation and the involvement of respiratory system. Methods： The clinical manifestations, auxiliary examination, and treatment were retrospectively analyzed in a case of sarcoidosis, along with literature review. Results： a 34 years old female was admitted to hospital because of skin rush for 4 months and chest tight- ness for two weeks. Skin biopsy showed non-caseous granulomatous infiltration. PAS staining, chest CT and fiberoptic bron- choscopy ruled out tuberculosis, tumor and fungal infection. She was diagnosed with sarcoidosis and responded well to gluco- corticoids. Conclusion： The sarcoidosis is often misdiagnosed because of its unspecific manifestations. Diagnosis relies on biopsy and imaging examination. Glucocorticoids is preferred after ruling out microbial infection and tumor.