Zisman D A, Biermann J S, Martinez F J, Devaney K O, Lynch J P
Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
Medicine (Baltimore). 1999 Mar;78(2):112-22. doi: 10.1097/00005792-199903000-00002.
Sarcoid myopathy presenting as a tumorlike lesion is an exceedingly rare presentation of sarcoidosis. Concurrent extramuscular involvement is common. Chest radiographs, if abnormal, may suggest the diagnosis. Magnetic resonance imaging is the preferred study for diagnosis and follow-up of tumorous sarcoid myopathy. Optimal therapy is not clear. Favorable responses have been cited with surgery or corticosteroids (alone or in combination). Azathioprine or alternative immunosuppressive agents (for example, antimalarials or methotrexate) may have a role in corticosteroid-recalcitrant patients. The role of local radiotherapy is controversial and should be reserved for severe localized disease refractory to aggressive medical therapy.
表现为肿瘤样病变的结节病性肌病是结节病极为罕见的一种表现形式。同时合并肌肉外受累很常见。胸部X线片若异常，可能提示诊断。磁共振成像（MRI）是诊断和随访肿瘤性结节病性肌病的首选检查。最佳治疗方法尚不清楚。手术或皮质类固醇（单独使用或联合使用）已被报道有良好疗效。硫唑嘌呤或其他免疫抑制剂（如抗疟药或甲氨蝶呤）可能对皮质类固醇难治性患者有效。局部放疗的作用存在争议，应仅用于对积极药物治疗无效的严重局限性疾病。
