Yamaguchi M, Ohta K, Takizawa H, Kobayashi N, Ishii A, Sugiyama H, Dohi M, Suko M, Ito K, Miyamoto T
Department of Medicine and Physical Therapy, University of Tokyo School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 May;33(5):533-7.
A 26-year-old man was admitted to our hospital for evaluation of cavitary lesions on his chest X-ray film. Chest CT and conventional tomograms showed multiple cavities in both lung fields, as well as hilar and mediastinal lymphadenopathy. He had uveitis and the laboratory data showed a high level of angiotensin converting enzyme in the serum. Histological findings of the specimen obtained by transbronchial lung biopsy showed non-caseating epithelioid cell granuloma, consistent with sarcoidosis. Corticosteroid therapy (prednisolone 40 mg/day) resulted in reduction of the cavitary lesions and the lymphadenopathy. Negative bacteriological studies and the clinical course strongly suggested primary cavitation, a relatively rare form of pulmonary parenchymal involvement in sarcoidosis.
一名26岁男性因胸部X光片上出现空洞性病变而入住我院。胸部CT和传统断层扫描显示双肺野有多个空洞，以及肺门和纵隔淋巴结肿大。他患有葡萄膜炎，实验室检查数据显示血清中血管紧张素转换酶水平升高。经支气管肺活检获取的标本组织学检查结果显示为非干酪样上皮样细胞肉芽肿，符合结节病表现。皮质类固醇治疗（泼尼松龙40毫克/天）使空洞性病变和淋巴结肿大减轻。细菌学检查阴性以及临床病程强烈提示为原发性空洞形成，这是结节病中一种相对少见的肺实质受累形式。
