Basnet Nishraj, Aluko Atinuke, Fenando Ardy, Rayamajhi Supratik
Department of Internal Medicine, Michigan State University, East lansing, Michigan, USA
Division of Rheumatology, John T Milliken Department of Medicine, Washington Univeristy School of Medicine in St. Louis, St. Louis, Missouri, USA.
BMJ Case Rep. 2021 Feb 8;14(2):e234767. doi: 10.1136/bcr-2020-234767.
A 43-year-old African American man presented with right upper quadrant pain and elevated blood pressure. Investigations revealed elevated lipase, hypercalcaemia and elevated creatinine. CT abdomen with contrast revealed extensive intraabdominal lymphadenopathy with an initial suspicion for a lymphoproliferative malignancy. Patient was managed for acute pancreatitis, with further workup of hypercalcaemia revealing an elevated ACE level. Inguinal lymph node biopsy confirmed a non-caseating granuloma leading to the diagnosis of sarcoidosis.
一名43岁的非裔美国男性因右上腹疼痛和血压升高前来就诊。检查发现脂肪酶升高、高钙血症和肌酐升高。腹部增强CT显示广泛的腹腔内淋巴结病，最初怀疑为淋巴增殖性恶性肿瘤。患者接受了急性胰腺炎的治疗，对高钙血症的进一步检查发现血管紧张素转换酶（ACE）水平升高。腹股沟淋巴结活检证实为非干酪样肉芽肿，从而确诊为结节病。
