单淋巴结肿大为首发症状的儿童结节病一例报告并文献复习

A Case of Childhood Sarcoidosis with Single Lymph Node Enlargement as the First Symptom

目的探讨儿童结节病(Childhood Sarcoidosis)的临床特点、诊治、鉴别诊断及预后,提高临床医师对该病的认知。方法分析1例福建医科大学附属第二医院儿科2022年7月收治的一名以单个淋巴结肿大为首发症状的儿童结节病患者的临床表现及病理学特点,并复习相关文献。结果9岁男性患者,以发现右侧腋窝肿物伴疼痛就医,初诊为“急性淋巴结炎”,经抗感染治疗后病情反复,后经淋巴结活检提示为非干酪性肉芽肿,最终诊断“淋巴结结节病”,予行基线病情评估及对症处理后好转出院,被建议长期随访。结论儿童结节病临床少见,以单淋巴结受累为首发表现的病例更是罕见,临床上往往忽略对该病的鉴别,因而延误病情,需提高对该病的认知,确诊后进行多系统评估,长期随访。

Objective To explore the clinical characteristics,diagnosis,differential diagnosis and prognosis of Childhood Sarcoidosis and improve clinicians'awareness of the disease.Methods Analyze the clinical manifestations and pathological characteristics of a Childhood sarcoidosis with a single lymph node enlargement as the first symptom admitted to the Second Affiliated Hospital of Fujian Medical University in July 2022,and review the relevant literature.Results 9-year-old male patients,went to the hospital with right axillary mass accompanied by pain,He was initially diagnosed as"acute lymphadenitis"and repeated symptoms after anti-infection treatment.Lymph node biopsy indicated non-caseous granuloma,and finally diagnosed as"lymph node sarcoidosis".After baseline condition assessment and symptomatic treatment,he was cured and discharged.Long-term follow-up is recommended.Conclusion Childhood sarcoidosis are rare,especially cases with single lymph node involvement as the first manifestation.The identification of the disease is often ignored in clinical practice,so the disease is delayed.It is necessary to improve the cognition of the disease,conduct multi-system evaluation after diagnosis,and carry out long-term follow-up.