Haneda H, Yamaguchi E, Okazaki N, Abe S, Kawakami Y, Nojima T
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Mar;27(3):367-72.
A 55-year-old woman was admitted for examination of bilateral hilar lymphadenopathy. Serum angiotensin converting enzyme was not elevated, but gallium-scan revealed an increased uptake in both lung hilus. The percentage of lymphocytes in the bronchoalveolar lavage fluid (BALF) was elevated (28.9%), and the proportion of OKIa1 positive cells was also elevated (50.5%). However, the ratio of cluster differentiation (CD) 4/8 was inverted at 0.5. Microscopic examination of the mediastinal lymph nodes revealed epithelioid cell granulomas without ceasation, and a diagnosis of sarcoidosis was made. Immunohistochemical examination of the lymph nodes showed predominancy of CD8 positive cells. Patients with pulmonary sarcoidosis having a low CD4/8 ratio in BALF are extremely rare in the early stage of sarcoidosis. The inverted CD4/8 ratio was of interest in regard to the pathogenesis of sarcoidosis.
一名55岁女性因双侧肺门淋巴结肿大入院检查。血清血管紧张素转换酶未升高，但镓扫描显示双侧肺门摄取增加。支气管肺泡灌洗液（BALF）中淋巴细胞百分比升高（28.9%），OKIa1阳性细胞比例也升高（50.5%）。然而，分化簇（CD）4/8比值倒置，为0.5。纵隔淋巴结显微镜检查显示上皮样细胞肉芽肿无干酪样坏死，诊断为结节病。淋巴结免疫组化检查显示CD8阳性细胞占优势。在结节病早期，BALF中CD4/8比值低的肺结节病患者极为罕见。CD4/8比值倒置对于结节病的发病机制具有重要意义。
