Iida K, Yoshinaga M, Kawamoto S, Fujii T, Kaseda M, Abe K, Matsubara Y, Shirai R, Kawakami K, Kadota J, Kohno S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Feb;36(2):197-202.
We describe a rare case of pulmonary sarcoidosis with multiple cavitation and pneumothorax. A 32-year-old woman was admitted to our hospital with a dry cough and an interstitial shadow with dense infiltrates in both upper lungs and cavitation in the right upper lung on chest roentgenogram and CT. Laboratory tests revealed an elevated level of serum lysozyme. BAL fluid demonstrated a high proportion of lymphocytes with an increased CD4/CD8 ratio, compatible with sarcoidosis. Transbronchial lung and skin biopsies showed evidence of noncaseating epithelioid-cell granuloma, and a diagnosis of sarcoidosis was made. Although pneumothorax appeared in the left lung on chest roentgenogram during clinical observation conservative treatment without corticosteroids or any other therapy for a follow-up period of 3 years resulted in improvement of her clinical condition and abnormal X-ray findings.
我们描述了一例罕见的伴有多发空洞和气胸的肺结节病病例。一名32岁女性因干咳入院，胸部X线片和CT显示双上肺有间质性阴影伴致密浸润，右上肺有空洞。实验室检查显示血清溶菌酶水平升高。支气管肺泡灌洗液显示淋巴细胞比例高，CD4/CD8比值增加，符合结节病表现。经支气管肺活检和皮肤活检显示有非干酪样上皮样细胞肉芽肿，从而确诊为结节病。尽管在临床观察期间胸部X线片显示左肺出现气胸，但在未使用皮质类固醇或任何其他治疗的情况下进行了3年的保守治疗，患者的临床状况和异常的X线表现均有改善。
