Matsui Takashi, Shirai Toshihiro, Uto Tomohiro, Imokawa Shiro, Chida Kingo, Nakamura Hirotoshi
Department of Internal Medicine, Fujinomiya City General Hospital, 3-1 Nishiki-cho, Fujinomiya, 418-0076, Japan.
Nihon Kokyuki Gakkai Zasshi. 2004 Jan;42(1):108-11.
A 36-year-old woman was referred to our hospital for investigation of erythema on the upper arms and thighs and abnormal radiological findings in the chest. A chest radiograph showed poorly defined fine nodules in both lung fields and high-resolution CT revealed fine nodular opacities with a random distribution throughout both lungs. No lymph node enlargement or peribronchovascular interstitial thickening were seen. Bronchoscopic evaluation revealed bronchial mucosal hypervascularity. Transbronchial lung biopsy and skin biopsy specimens showed noncaseating epithelioid cell granulomas. These findings confirmed the diagnosis of sarcoidosis. This is a rare case of sarcoidosis presenting with atypical high-resolution CT findings, which are difficult to differentiate from those of miliary tuberculosis or metastatic carcinoma.
一名36岁女性因上臂和大腿出现红斑以及胸部放射学检查异常而转诊至我院。胸部X光片显示双肺野有边界不清的小结节,高分辨率CT显示双肺弥漫性随机分布的小结节状阴影。未见淋巴结肿大或支气管血管周围间质增厚。支气管镜检查显示支气管黏膜血管增多。经支气管肺活检和皮肤活检标本显示非干酪样上皮样细胞肉芽肿。这些发现确诊为结节病。这是一例罕见的结节病,其高分辨率CT表现不典型,难以与粟粒性肺结核或转移性癌相鉴别。