Kitamura M, Ishizaki T
Dept. of Int. Med., Fukui Medical School.
Nihon Rinsho. 1994 Jun;52(6):1595-8.
Although liver and/or spleen sarcoidosis usually shows no symptoms and subtle elevated levels of liver enzymes, diagnostic image scanning methods (abdominal ultrasonic scan, computed tomographic scan, magnetic resonance image, and Ga and Tc scintiscan) can easily detect the lesion. Laparoscopy unveils isolated scattered sarcoid nodules on the surface of the liver and/or spleen and biopsied specimen reveal a non-caseating epithelioid granuloma containing multinucleated giant cells especially in the portal area. Sometimes it is required to differentiate liver and/or spleen sarcoidosis from hepatic tuberculosis, primary biliary cirrhosis or malignant lymphoma. In severe cases, corticosteroid treatment is necessary. Prognosis is usually good, but may be poor in some cases.
尽管肝脏和/或脾脏结节病通常没有症状,且肝酶水平略有升高,但诊断性影像扫描方法(腹部超声扫描、计算机断层扫描、磁共振成像以及镓和锝闪烁扫描)能够轻松检测到病变。腹腔镜检查可发现肝脏和/或脾脏表面孤立散在的结节病结节,活检标本显示为非干酪样上皮样肉芽肿,尤其在门静脉区域含有多核巨细胞。有时需要将肝脏和/或脾脏结节病与肝结核、原发性胆汁性肝硬化或恶性淋巴瘤相鉴别。在严重病例中,需要进行皮质类固醇治疗。预后通常良好,但在某些情况下可能较差。