Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Wuhan, China.
BMC Pulm Med. 2020 Nov 12;20(1):296. doi: 10.1186/s12890-020-01340-2.
Mucosal nodules can be caused by infection, inflammation and neoplastic disease. Many noninfectious diseases, such as eosinophilia, amyloidosis, sarcoidosis, Wegener's granuloma, langerhans cell histiocytosis etc., are associated with the formation of multisytem mucosal nodules, especially significant bronchial lesions. Detailed medical history, comprehensive metabolic profile, biopsy specimen and imaging examinations are required for differentiating among these disorders. The process of diagnosis and treatment of our patient's mucosal nodules was challenging, which could be helpful to similar cases.
We represent a case of a 29-year-old woman with plentiful nodules of unknown origin on extensive mucous membranes. Biopsy specimen reports inflammatory lesions with large numbers of neutrophils, lymphocytes, and varying degrees of eosinophils. Treatment of anti-infection, anti-tussive and anti-allergic was ineffective, but glucocorticoid showed great improvement to her symptoms.
We experienced a rare case with plentiful nodules of unknown origin on extensive mucous membranes. She may be a specific phenotype of eosinophilia or may be a novel multisystem disease with respiratory system as the primary symptom. The diagnosis of our patient remains unclear, but tentative glucocorticoid therapy was beneficial.
黏膜结节可由感染、炎症和肿瘤性疾病引起。许多非传染性疾病,如嗜酸性粒细胞增多症、淀粉样变性、结节病、韦格纳肉芽肿、朗格汉斯细胞组织细胞增生症等,与多系统黏膜结节的形成有关,尤其是显著的支气管病变。鉴别这些疾病需要详细的病史、全面的代谢谱、活检标本和影像学检查。我们的患者黏膜结节的诊断和治疗过程极具挑战性,这可能对类似病例有帮助。
我们报告了一例 29 岁女性,广泛黏膜上有大量不明来源的结节。活检报告显示炎症性病变,大量中性粒细胞、淋巴细胞和不同程度的嗜酸性粒细胞浸润。抗感染、止咳和抗过敏治疗无效,但糖皮质激素对她的症状有很大改善。
我们遇到了一例罕见的广泛黏膜上有大量不明来源结节的病例。她可能是嗜酸性粒细胞增多症的一种特殊表型,也可能是一种以呼吸系统为主要表现的新型多系统疾病。我们患者的诊断仍不明确,但糖皮质激素治疗可能有益。