What Is Pulmonary Sarcoidosis?

Unexplained multi-system, multi-organ granulomatous disease. Lesions are most common in lung and intrathoracic lymph nodes, and are characterized by non-cheese necrotizing granulomatous lesions. Early asymptomatic, mostly found by X-ray, the lesions can involve liver, spleen, peripheral lymph nodes, eyes, bone, skin, parotid glands, etc. Kveim (+), bronchoalveolar lavage fluid examination and lymph node, lung biopsy can help diagnosis. The prognosis is mostly good, and important organs and active lesions need to be treated with adrenal corticosteroids.

Sarcoidosis

Unexplained multi-system, multi-organ granulomatous disease. Lesions are most common in lung and intrathoracic lymph nodes, and are characterized by non-cheese necrotizing granulomatous lesions. Early asymptomatic, mostly found by X-ray, the lesions can involve the liver, spleen, peripheral lymph nodes,

Pulmonary sarcoidosis is also called sarcoidoma, Bowe's sarcoma, etc. It belongs to a non-cheese granuloma. Rarely domestic. There are obvious regional characteristics. There are more temperate zones, and the incidence is higher in Europe. As far as race is concerned, blacks are the most common, whites are the second, and yellows are rare. Women are slightly more common. Onset can occur at any age, and the age of onset is more common in 20-50 years old. The course of the disease varies greatly, with a tendency to heal itself.

The cause is unclear, and most are thought to be related to viral infection. The basic pathological changes of sarcoidosis are non-cheese granuloma (composed of epithelioid cells, Langerhans giant cells, lymphocytes and fibroblasts), which can invade systemic lymph nodes, lungs, eyes, skin, liver, bone, etc. organization. Lesions can be in the lymph nodes or lung parenchyma. Nodules can be completely absorbed within months, or they can be replaced by fibrous tissue, forming diffuse fibrosis of the lung interstitial.

Most clinically asymptomatic or only slight respiratory symptoms, negative chest signs. Systemic peripheral lymphadenopathy accounts for about 40%. Hepatosplenomegaly accounts for about 20%. Erythrocyte sedimentation increased, and intradermal tuberculin tests were often negative.

Sarcoidosis is often diagnosed with lymphoma, lymph node tuberculosis, metastases, and mediastinal lymph node metastases from lung cancer. Lymphoma usually starts from paratracheal lymph nodes, which most often involve paratracheal lymph nodes, hilum, and internal breast lymph nodes. Single lymph nodes are involved early. When the tumor is small, the X-ray manifestations are mild and more difficult to confirm. When the lymph nodes increase significantly, their typical X The lines are symmetrically widened on both sides of the mediastinum. The tumor is mainly on both sides of the trachea, which can compress the narrowing of the trachea. The edge of the tumor is clearly wavy or obvious lobes. This type of tumor is more sensitive to radiation. Big. Lymph node tuberculosis usually occurs in children or young people, while sarcoidosis is often in adults. Lymph node tuberculosis is often unilateral, and a positive tuberculin test indicates tuberculosis. Primary lung tumors and metastatic tumors of the lung are often accompanied by mediastinal and hilar lymphadenopathy, but they occur in middle-aged and elderly people. Primary lung tumors often present as a single lesion in the lung. Most metastatic tumors have primary extrapulmonary lesions.

Symmetrical hilar and paratracheal mediastinal lymphadenopathy with lobulated masses with clear and sharp borders. Paratracheal lymph nodes on one or both sides are enlarged, often on the right side, with hilar Lymph nodes increase. Lymph nodes are mostly moderately enlarged with clear edges and multiple nodules are potato-shaped. In about 60% of cases, when hilar lymph nodes shrink and fade, diffuse miliary (1 to 5 mm in diameter) nodules appear in both lung fields, accompanied by reticular fibrous stripe shadows. The hilar lymph nodes and lung infiltrates were fully absorbed. However, in 15% to 20% of cases, lung lesions are not absorbed and are transformed into pulmonary interstitial fibrosis, which eventually leads to respiratory failure or pulmonary heart disease. Enlarged lymph nodes compressing the bronchi can cause emphysema or atelectasis, involving cyst-like changes in the toes and fingers of the bones, and prone to kidney stones. Glucocorticoid therapy can promote lesion absorption.