Wang Feng, Tong Zhaohui, Wang Zhen, Wang Xiaojuan, Xu Lili
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
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Zhonghua Jie He He Hu Xi Za Zhi. 2015 Feb;38(2):99-104.
To summarize the clinical features and the diagnosis-treatment points of sarcoidosis related pleural effusion.
Six typical sarcoidosis related pleural effusion cases with pathological evidence were reviewed, and the clinical data of these cases were retrospectively analyzed and the related literatures were reviewed. The literature review was carried out respectively with "sarcoidosis", "pleural disease" and "pleural effusion" as the keywords in CNKI and PubMed database by January 2014.
Six cases, including 1 male and 5 females, with sarcoidosis related pleural effusions were reported. 3 cases had bilateral effusions, 2 cases had left effusion and 1 case had right effusion. The pleural effusion routine test had a low specificity, which demonstrated that the fluid was exudate and consisted with large number of lymphocytes. 3 of these cases were diagnosed by medical thoracoscopy. Medical thoracoscopy revealed that pleural involvement was variable with multiple nodulespresent in some cases and subtle change in others. A total of 28 literatures and 92 cases with pleural involvement in sarcoidosis were retrieved from CNKI and PubMed database (time range: 2004.1-2014.1), including 59 cases of pleural effusion, 29 cases of pleural thickening, 3 cases of pneumothorax and 1 case of nodules in pleura.
Pleural involvement in sarcoidosis was often misdiagnosed or mistreated as tuberculous pleurisy because the routine tests regarding pleural effusion usually had a low specificity. Medical thoracoscopy could provide clinicians with important clues to assist differentiation of the cause for non-conclusive pleural effusion in this situation.
总结结节病相关胸腔积液的临床特征及诊治要点。
回顾6例有病理证据的典型结节病相关胸腔积液病例，对这些病例的临床资料进行回顾性分析，并复习相关文献。分别以“结节病”、“胸膜疾病”和“胸腔积液”为关键词，在CNKI和PubMed数据库中检索截至2014年1月的相关文献。
报告6例结节病相关胸腔积液病例，其中男性1例，女性5例。3例为双侧胸腔积液，2例为左侧胸腔积液，1例为右侧胸腔积液。胸腔积液常规检查特异性低，提示为渗出液，以大量淋巴细胞为主。其中3例经内科胸腔镜确诊。内科胸腔镜检查显示胸膜受累情况各异，部分病例可见多个结节，部分病例则有细微改变。从CNKI和PubMed数据库（时间范围：2004.1 - 2014.1）共检索到28篇文献及92例结节病胸膜受累病例，其中胸腔积液59例，胸膜增厚29例，气胸3例，胸膜结节1例。
由于胸腔积液常规检查特异性通常较低，结节病的胸膜受累常被误诊或误治为结核性胸膜炎。内科胸腔镜可为临床医生提供重要线索，有助于鉴别这种情况下病因不明的胸腔积液。
