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多发性结节病合并干燥综合征:病例报告及文献复习。

Multisystem Sarcoidosis Combined with Sjögren's Syndrome: A Case Report and Literature Review.

机构信息

Department of Radiology, Nanjing Gaochun People's Hospital, Nanjing, Jiangsu, P.R, China.

Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R, China.

出版信息

Curr Med Imaging. 2023;19(13):1599-1603. doi: 10.2174/1573405619666230215150154.

Abstract

BACKGROUND

Sarcoidosis is a systemic non-caseous necrotizing granulomatous disease with unknown etiology. It can involve multiple organs throughout the body, most commonly affecting lungs and/or bilateral hilar lymph nodes. Sjögren's syndrome is a multi-system autoimmune disease. The main clinical symptoms include dry mouth and dry eyes. The combination of the two diseases with the involvement of multiple systems is very rare, and the final diagnosis is mainly based on the comprehensive judgment of clinical history, imaging manifestations and pathological examination.

CASE PRESENTATION

We report a case of multiple sarcoidosis (lung, hilar, mediastinal, inguinal, liver, and spleen) with Sjögren syndrome. The patient had a dry mouth, dry eyes, and bilateral parotid gland enlargement. The first computed tomography (CT) scan of the chest and abdomen showed multiple nodules in the lungs, multiple enlarged lymph nodes, and low-density shadows in the liver and spleen. After a one-year interval, the re-examination showed that the lung lesions increased with bead-like changes, and the lymph nodes shrunk. Through pathological puncture and comprehensive judgment, considering the coexistence of the two diseases, the patient improved after hormone therapy and was finally diagnosed.

CONCLUSION

Multisystem sarcoidosis combined with Sjögren's syndrome has rarely been reported in the literature. This case has multiple imaging examinations, pathological data and a follow-up review after treatment. The dynamic changes in different periods will help us to better understand the situation of sarcoidosis and explore the connection between the two diseases so as to reduce misdiagnosis.

摘要

背景

结节病是一种病因不明的全身性非干酪样坏死性肉芽肿性疾病。它可以累及全身多个器官,最常累及肺部和/或双侧肺门淋巴结。干燥综合征是一种多系统自身免疫性疾病。主要临床症状包括口干和眼干。这两种疾病合并累及多个系统的情况非常罕见,最终诊断主要基于临床病史、影像学表现和病理检查的综合判断。

病例介绍

我们报告了一例伴有干燥综合征的多发性结节病(肺、肺门、纵隔、腹股沟、肝和脾)。患者有口干、眼干和双侧腮腺肿大。胸部和腹部的第一次计算机断层扫描(CT)显示肺部多个结节、多个淋巴结肿大和肝脏及脾脏低密度影。一年后复查显示肺部病变增多并有串珠样改变,淋巴结缩小。通过病理穿刺及综合判断,考虑两种疾病共存,患者经激素治疗后好转,最终确诊。

结论

结节病合并干燥综合征在文献中鲜有报道。本病例有多个影像学检查、病理数据和治疗后的随访复查。不同时期的动态变化有助于我们更好地了解结节病的情况,并探讨两种疾病之间的联系,以减少误诊。

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