Seki K, Sakatani M, Tachibana T
Department of Internal Medicine, Kawanishi Municipal Hospital, Hyôgo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jan;28(1):74-9.
Varieties of extrapulmonary sarcoidosis lesions have been detected in Japan, mostly in the past ten years, including heart, CNS, liver, spleen, bone marrow stomach, colon, esophagus, pancreas, gall bladder, abdominal lymph node, kidney, muscle, bone, joint and others. Most of these were detected mainly at onset with sarcoid changes on chest film. Hepatic lesions have frequently been found by peritoneoscopy and liver biopsy, irrespective of the age of patients or stage of sarcoid change on chest film. Therefore hepatic lesions are very important in the diagnosis and following the clinical course of sarcoidosis. Recent diagnostic procedures of extrapulmonary lesion include abdominal, cardiac and muscle echography; brain, chest, abdominal and muscle CT; cardiac and muscle MRI; gallium scan; thallium myocardial scan, cardiac pool scan and Holter ECG. Extrapulmonary sarcoidosis lesions causing disability were located in the heart, CNS, eye, liver, kidney, muscle and bone. These disabilities were found predominantly in cases older than 40 years old, and were mainly detected at onset in the past 10 years. The duration of some of these disabilities was more than 10 years.
在日本已检测到多种肺外结节病病变，大多是在过去十年间发现的，包括心脏、中枢神经系统、肝脏、脾脏、骨髓、胃、结肠、食管、胰腺、胆囊、腹部淋巴结、肾脏、肌肉、骨骼、关节等。其中大多数主要在发病时通过胸部X光片上的结节样改变被检测到。无论患者年龄或胸部X光片上结节样改变的阶段如何，通过腹腔镜检查和肝脏活检经常能发现肝脏病变。因此，肝脏病变在结节病的诊断和临床病程追踪中非常重要。近期肺外病变的诊断方法包括腹部、心脏和肌肉超声检查；脑部、胸部、腹部和肌肉CT；心脏和肌肉MRI；镓扫描；铊心肌扫描、心血池扫描和动态心电图。导致残疾的肺外结节病病变位于心脏、中枢神经系统、眼睛、肝脏、肾脏、肌肉和骨骼。这些残疾主要出现在40岁以上的病例中，且主要是在过去10年发病时被检测到。其中一些残疾的持续时间超过了10年。
