Noguchi H, Hirai K, Seo A, Yoshitake M, Sakai T, Abe H, Hidaka R, Aritaka T, Tanikawa K
Second Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Intern Med. 1993 Jan;32(1):15-20. doi: 10.2169/internalmedicine.32.15.
A 64-year-old male complained of weight loss and slight fever. Bilateral hilar lymphadenopathy and hepato-splenomegaly were observed. Serum ACE level was high, and liver function was impaired. Laparoscopy demonstrated small white nodules on the liver surface. A definite diagnosis of sarcoidosis was made by histological study of the specimen by liver biopsy and noncaseating epithelioid cell granulomas composed of giant cells and epithelioid cells were revealed. Various pancreatic enzymes were increased on admission, suggesting pancreatic impairment due to sarcoidosis. Corticosteroid therapy improved liver and pancreatic functions and decreased splenomegaly. He has been followed up for 4 years and 5 months.
一名64岁男性主诉体重减轻和低热。观察到双侧肺门淋巴结肿大及肝脾肿大。血清血管紧张素转换酶（ACE）水平升高，肝功能受损。腹腔镜检查发现肝脏表面有小白结节。通过肝活检标本的组织学研究明确诊断为结节病，可见由巨细胞和上皮样细胞组成的非干酪样上皮样细胞肉芽肿。入院时各种胰腺酶升高，提示结节病所致胰腺损害。皮质类固醇治疗改善了肝脏和胰腺功能，并减轻了脾肿大。对其进行了4年零5个月的随访。
