Kawano H, Hirata M, Murakami S, Maki K, Yoneda S, Kajita Y, Fujita Y
Department of Internal Medicine, Nantan General Hospital, Kyoto, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Dec;34(12):1375-9.
An 82-year-old woman with blurred vision consulted an ophthalmologist. She was admitted to the hospital (internal medicine) for further examination because of uveitis and cataracts. A chest X-ray film and a CT scan showed interstitial infiltration in the right middle lung field, and a Ga-scintigram showed abnormal accumulation in the same area. The mediastinal lymph nodes were not swollen, and the left lung appeared to be normal. We diagnosed her illness as sarcoidosis because the CD4/CD8 of bronchoalveolar lavage fluid from the right B4 was greater than 5.0 and because examination of a specimen obtained by transbronchial lung biopsy from the right B4 showed many non caseous epithelioid granulomas. In contrast bronchoalveolar lavage fluid from the left B4 had a CD4/CD8 of less than 2.0 and examination of a biopsy specimen from the left B4 showed normal lung tissue. The lesion in this patient was only in the right lung, and was classified as Stage 3. However, because the lung fibrosis and the reduction in pulmonary function were minimal, the disease in this case did not fit the conventional classification into stages.
一位视力模糊的82岁女性咨询了眼科医生。她因葡萄膜炎和白内障被收治入院（内科）作进一步检查。胸部X光片和CT扫描显示右肺中叶有间质浸润，镓闪烁扫描显示同一区域有异常聚集。纵隔淋巴结未肿大，左肺看起来正常。我们将她的病情诊断为结节病，因为右B4支气管肺泡灌洗 fluid的CD4/CD8大于5.0，且对右B4经支气管肺活检获取的标本检查显示有许多非干酪样上皮样肉芽肿。相比之下，左B4支气管肺泡灌洗fluid的CD4/CD8小于2.0，对左B4活检标本的检查显示为正常肺组织。该患者的病变仅在右肺，被分类为3期。然而，由于肺纤维化和肺功能减退很轻微，该病例的疾病不符合传统的分期分类。 （注：原文中“bronchoalveolar lavage fluid”多次表述不完整，可能影响理解，翻译时保留了原文表述。）
