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组织病理学对结节病诊断的辅助作用:8例报告

Histopathologic aid to diagnosis of sarcoidosis: report of 8 cases.

作者信息

Manonukul Jane, Wanitphakdeedecha Rungsima, Wisuthsarewong Wanee, Thirapote Panitta

机构信息

Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2006 Jun;89(6):864-71.

Abstract

Sarcoidosis is a multisystemic disease of unknown etiology. The disease is common in blacks and is very rare in Thailand. It presents as one of the most variable manifestations usually affecting the lungs and intrathoracic lymph nodes. Other organs such as liver, spleen, joints and eyes including skin are also involved The common cutaneous lesions are maculopapular, erythematous plaque, subcutaneous nodule, scar and lupus pernio. No reliable indicator is useful for diagnosis except the histopathologic change which is the only way for approaching this disease. Sarcoidosis is the disease of exclusion. Various infections producing granulomas should be excluded histologically. The ultimate diagnosis requires clinical correlation, laboratory investigations, chest X-ray as well as available tissue culture. Herein, the authors reported eight cases of sarcoidosis by retrospective study primarily diagnosed by histopathological findings at Siriraj Hospital from January, 1997 to December, 2004 with many different clinical presentations. Despite the diverse clinical pictures, interestingly, the presented patients almost had the same histopathologic findings as small, uniform, discrete naked granulomas usually without necrosis. These findings act as a hallmark for diagnosis of this disease.

摘要

结节病是一种病因不明的多系统疾病。该疾病在黑人中常见,在泰国则极为罕见。它表现为最具多样性的病症之一,通常累及肺部和胸内淋巴结。其他器官如肝脏、脾脏、关节、眼睛以及皮肤也会受到影响。常见的皮肤损害有斑丘疹、红斑性斑块、皮下结节、瘢痕和冻疮样狼疮。除了组织病理学改变这一诊断该疾病的唯一途径外,没有可靠的指标可用于诊断。结节病是一种排除性疾病。应通过组织学排除各种产生肉芽肿的感染。最终诊断需要结合临床、实验室检查、胸部X线以及可用的组织培养结果。在此,作者通过回顾性研究报告了8例结节病病例,这些病例主要于1997年1月至2004年12月在诗里拉吉医院通过组织病理学检查确诊,临床表现多样。尽管临床表现各异,但有趣的是,这些患者几乎都有相同的组织病理学表现,即通常无坏死的小而均匀、离散的裸肉芽肿。这些表现是诊断该疾病的标志。

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