Faller M, Purohit A, Kennel N, de Blay F, Sahel J, Pauli G
Service de Pneumologie, Hôpital Civil, Strasbourg, France.
Eur Respir J. 1995 Mar;8(3):474-6. doi: 10.1183/09031936.95.08030474.
A 73 year old woman presented with redness, itching and painless proptosis of the left eye. Clinical examination and computed tomographic (CT) scan of the orbit revealed a postero-ocular mass, the biopsy of which showed a noncaseating, giant cellular, epithelioid granuloma compatible with sarcoidosis. The patient had no respiratory complaints, but the thoracic CT scan showed multiple bilateral hilar and mediastinal adenopathies. Gallium scan showed increased uptake in both hilar regions, in the left orbit and in the right parotid gland. Multiple bronchial biopsies revealed sarcoid granulomas, with a bronchoalveolar lavage (BAL) cytological pattern of active sarcoidosis. The evolution was favourable with prednisolone given at a dose of 0.5 mg.kg-1 daily. It is suggested that in an unusual presentation of sarcoidosis, a thorough search should be made for localization at other sites, lungs in particular, even in the absence of respiratory complaints.
一名73岁女性因左眼发红、瘙痒且无痛性眼球突出就诊。眼眶的临床检查和计算机断层扫描（CT）显示眼后有肿物，活检显示为非干酪样、巨细胞、上皮样肉芽肿，符合结节病表现。患者无呼吸道症状，但胸部CT扫描显示双侧肺门及纵隔多发淋巴结肿大。镓扫描显示双侧肺门区域、左眼眶及右腮腺摄取增加。多次支气管活检发现结节病肉芽肿，支气管肺泡灌洗（BAL）细胞学表现为活动期结节病。给予泼尼松龙每日0.5mg·kg-1治疗后病情好转。提示在结节病不典型表现时，即使无呼吸道症状，也应全面检查其他部位，尤其是肺部是否存在病变。
