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[结节病的胃部定位]

[Gastric localization of sarcoidosis].

作者信息

Moretti A M, Sallustio G, Attimonelli R, Arezzo C, Neri D, Losito A

机构信息

II Divisione di Pneumologia, USL BA/9, Bari.

出版信息

Recenti Prog Med. 1993 Nov;84(11):750-5.

PMID:8290786
Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology, characterized by an immunological disorder with accumulation of activated lymphocytes and macrophages in all the organs and apparatus. The intrathoracic lymphnodes and the lung remain the most common sites of such disease. The gastrointestinal sarcoidosis, particularly of the stomach, is very rare. The stomach may be the primitive or the secondary (systemic sarcoidosis) site of sarcoid granuloma. The endoscopic aspects of the gastric mucosa are variable: localized or diffused hyperemia, single or multiple ulcers, aspects of atrophic gastritis with easy bleeding during contact, rigid mucosa and so on. Generally asymptomatic, the disease may show symptoms as pain in the epigastrium, nausea, vomiting, haematemesis and so on. The wide range of gastric pathologies resembling sarcoidosis both on a histological level and on a clinic-endoscopical one (syphilis, histoplasmosis, Crohn's disease, stomach cancer) require an extremely accurate diagnosis above all for the setting out of the therapy with steroids which are the most appropriate drugs (prednisone). Three out of thirty-two patients observed for respiratory problems, already affected by cutaneous and pulmonary sarcoidosis, started suffering from gastric symptoms of different kind: pain in the epigastrium, haematemesis, weight loss, nausea and post-prandial vomiting. Gastroscopy and biopsy, with histopathologic examination of gastric mucosal specimens taken from the most suspicious sites, confirmed the diagnosis of sarcoidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

结节病是一种病因不明的全身性肉芽肿疾病,其特征为免疫紊乱,活化淋巴细胞和巨噬细胞在所有器官和组织中积聚。胸内淋巴结和肺仍是该疾病最常见的部位。胃肠道结节病,尤其是胃部结节病非常罕见。胃可能是结节性肉芽肿的原发部位或继发部位(全身性结节病)。胃黏膜的内镜表现多种多样:局限性或弥漫性充血、单发或多发溃疡、接触时易出血的萎缩性胃炎表现、黏膜僵硬等。该疾病通常无症状,也可能表现为上腹部疼痛、恶心、呕吐、呕血等症状。在组织学层面以及临床内镜层面,多种胃部病变都可能与结节病相似(梅毒、组织胞浆菌病、克罗恩病、胃癌),因此首先需要极其准确的诊断,以便制定使用类固醇(泼尼松)这种最合适药物的治疗方案。在因呼吸问题接受观察的32例患者中,已有皮肤和肺部结节病,其中3例开始出现不同类型的胃部症状:上腹部疼痛、呕血、体重减轻、恶心和餐后呕吐。胃镜检查和活检,对取自最可疑部位的胃黏膜标本进行组织病理学检查,确诊为结节病。(摘要截断于250字)

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