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[一例自发性缓解14年后复发并伴有胸膜炎的结节病]

[A case of relapsing sarcoidosis with pleurisy 14 years after spontaneous remission].

作者信息

Ohba Hisano, Miwa Seiichi, Shirai Masahiro, Suda Takafumi, Hayakawa Hiroshi, Chida Kingo

机构信息

Department of Internal Medicine, National Hospital Organization Tenryu Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2010 Aug;48(8):632-5.

Abstract

An 83-year-old woman was referred to our hospital with dyspnea on exertion and right pleural effusion. At the age of 69, she had been given a clinical diagnosis of sarcoidosis due to uveitis, bilateral hilar lymphadenopathy, bilateral multiple nodular shadows on chest images, and serum angiotensin-converting enzyme (SACE) level elevation. Remission was spontaneous. The pleural effusion was exudative lymphocyte-rich. On thoracoscopy, the macroscopic appearance of the parietal pleura was telangiectasia without nodular lesions and the pleural biopsy specimens revealed non-caseating epitheloid cell granulomas whose cultures were negative for acid-fast bacilli and fungi. A tuberculin skin test and QFT-2G were negative, thus we diagnosed sarcoidsis pleurisy.

摘要

一名83岁女性因劳力性呼吸困难和右侧胸腔积液转诊至我院。69岁时,她因葡萄膜炎、双侧肺门淋巴结肿大、胸部影像显示双侧多发结节状阴影以及血清血管紧张素转换酶(SACE)水平升高,被临床诊断为结节病。病情自发缓解。胸腔积液为富含淋巴细胞的渗出液。胸腔镜检查时,壁层胸膜的宏观表现为毛细血管扩张,无结节性病变,胸膜活检标本显示非干酪样上皮样细胞肉芽肿,其培养物抗酸杆菌和真菌均为阴性。结核菌素皮肤试验和QFT-2G均为阴性,因此我们诊断为结节病性胸膜炎。

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