Ohmichi Mitsuhide
Ohmichi Clinic of Internal and Respiratory Medicine.
Nihon Rinsho. 2002 Sep;60(9):1759-65.
In Japan, elderly patients with sarcoidosis, cardiac sarcoidosis and severe pulmonary sarcoidosis patients have been increased. The patients with ocular manifestations without intrathoracic involvement have been also increased and it is, however, difficult to establish the diagnosis and to confirm such patients as sarcoidosis. To detect the histological findings such as epithelioid cell granuloma is gold standard in diagnosis. Transbronchial lung biopsy, scalene node biopsy, muscle biopsy and video-assisted thoracoscopic surgery are useful procedure for getting the tissue samples. We performed TBLB in 655 patients with clinical features of sarcoidosis. In 125 out of 293 patients with stage 0, 229 out of 272 with stage I, 66 out of 70 with stage II and 19 out of 20 with stage III patients, epithelioid cell granuloma was found. The effort to getting proper tissue samples of suspected sarcoidosis is important.
在日本,结节病老年患者、心脏结节病患者以及重度肺部结节病患者的数量一直在增加。无胸内受累的眼部表现患者数量也在增加,然而,确诊此类患者为结节病并加以证实却很困难。检测组织学表现如上皮样细胞肉芽肿是诊断的金标准。经支气管肺活检、斜角肌淋巴结活检、肌肉活检以及电视辅助胸腔镜手术是获取组织样本的有用方法。我们对655例有结节病临床特征的患者进行了经支气管肺活检。在293例0期患者中的125例、272例I期患者中的229例、70例II期患者中的66例以及20例III期患者中的19例中发现了上皮样细胞肉芽肿。获取疑似结节病的合适组织样本的工作很重要。