Matsuura Shun, Mochizuka Yasutaka, Oishi Kyohei, Miyashita Koichi, Naoi Hyogo, Mochizuki Eisuke, Mikura Shinichiro, Tsukui Masaru, Koshimizu Naoki, Ohata Akihiko, Suda Takahumi
Division of Respiratory Internal Medicine, Fujieda Municipal General Hospital, Japan.
Division of Gastroenterology, Fujieda Municipal General Hospital, Japan.
Intern Med. 2017 Nov 15;56(22):3083-3087. doi: 10.2169/internalmedicine.8916-17. Epub 2017 Sep 25.
Sarcoidosis affects multiple organs and rarely has unusual manifestations. A 78-year-old woman was referred to our hospital for coughing symptoms. A chest computed tomography (CT) scan revealed bilateral diffuse miliary patterns and right pleural effusion. Bronchoscopy showed multiple nodules in the carina and the bronchus intermedius. A CT scan of her abdomen revealed hypovascular lesions involving the pancreatic head and body. A transbronchial lung biopsy, bronchial mucosal biopsy, and endoscopic ultrasound-guided fine-needle aspiration of the pancreatic mass demonstrated non-caseating granulomas. We diagnosed the patient with sarcoidosis. She received no treatment for sarcoidosis and has been followed up for one year, during which no pulmonary disease progression had been observed and the pancreatic masses partially regressed.
结节病可累及多个器官,且很少有不寻常的表现。一名78岁女性因咳嗽症状转诊至我院。胸部计算机断层扫描(CT)显示双侧弥漫性粟粒样改变及右侧胸腔积液。支气管镜检查显示隆突和中间支气管有多个结节。腹部CT扫描显示胰头和胰体有低血运病变。经支气管肺活检、支气管黏膜活检及内镜超声引导下胰腺肿块细针穿刺均显示非干酪样肉芽肿。我们诊断该患者为结节病。她未接受结节病治疗,已随访一年,在此期间未观察到肺部疾病进展,胰腺肿块部分消退。