Luchansky Michael, Bergman Michael, Salman Hertzel
Department of Medicine C, Golda Campus (Hasharon), Rabin Medical Center, Petah Tiqva, Israel.
Harefuah. 2004 Jun;143(6):401-3, 464.
Sarcoidosis is a multi-system granulomatous disease that mainly affects the lungs and the lymphatic system. Involvement of the digestive system is rare, while the presentation of a mass in the pancreas as the first sign of sarcoidosis in the digestive system is yet rarer. Very few cases have been reported in the literature. The presentation of a mass in the pancreas is indicative of malignancy or inflammation and thus makes the diagnosis of sarcoidosis very difficult. Often it is discovered only after surgical intervention. We present a case study in which the involvement of the pancreas, bile ducts and mesentery lymph nodes led to a Whipple operation. However, on biopsy, non-caseating granulomas were found with no signs of malignancy. In view of the difficulties in diagnosing sarcoidosis of the digestive system and pancreas, we present a review of the literature on the diagnosis and management of this form of sarcoidosis.
结节病是一种多系统肉芽肿性疾病，主要累及肺部和淋巴系统。消化系统受累较为罕见，而胰腺出现肿块作为消化系统结节病的首发症状则更为罕见。文献中报道的病例极少。胰腺出现肿块提示恶性肿瘤或炎症，因此结节病的诊断非常困难。通常只有在手术干预后才会发现。我们报告一例病例，该病例中胰腺、胆管和肠系膜淋巴结受累导致了惠普尔手术。然而，活检发现非干酪样肉芽肿，无恶性迹象。鉴于消化系统和胰腺结节病诊断困难，我们对这种形式的结节病的诊断和治疗文献进行了综述。
