胸内淋巴结结节病。内科临床一例报告

S. N. Demidik, K. M. Surmach, E. N. Aleksa, N. G. Borisovskaja
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引用次数: 0

摘要

结节病是一种病因不明的多系统炎性疾病。胸部x线摄影用于检测肺或胸内淋巴结的病理变化。肺结节病的典型影像学表现为双侧对称的肺门及纵隔淋巴结肿大。淋巴结呈球形或卵圆形,结构均匀,轮廓光滑清晰,无病灶周围浸润和硬化。结节病胸腔内淋巴结病变的不典型表现是罕见的。本临床病例表明高分辨率计算机断层扫描在胸内淋巴结病综合征患者中的重要性。需要注意的是,发现单侧或不对称的肝门淋巴结肿大、纵隔和心包淋巴结群肿大并不排除结节病可能的病理原因,需要形态学上的诊断证实。从个体化医疗和临床建议的角度讨论了这个案例。
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INTRATHORACIC LYMPH NODES SARCOIDOSIS. A CLINICAL CASE REPORT IN INTERNAL MEDICINE PRACTICE
Sarcoidosis is a multisystem inflammatory disease of unknown etiology. Thoracic radiography is used to detect pathological changes in the lungs or intrathoracic lymph nodes. The classic image finding of pulmonary sarcoidosis is bilateral, symmetrical hilar and mediastinal lymph nodes enlargement. Lymph nodes are spherical or ovoid shape and homogeneous structure, with smooth clear contours, and without perifocal infiltration and sclerosis. Atypical manifestations of intrathoracic lymphadenopathy in sarcoidosis can be detected rarely. The presented clinical case indicates the importance of high-resolution computed tomography in patients with intrathoracic lymphadenopathy syndrome. It has to be noted that the detection of unilateral or asymmetric enlargement of hilar lymph nodes, the enlargement of mediastinal and pericardial groups of lymph nodes does not exclude sarcoidosis as a possible cause of pathology and requires morphological confirmation of the diagnosis. The case is discussed from the standpoint of personalized medicine and clinical recommendations.
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