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肉状瘤病是一种会导致炎症,原因不明的疾病。肉状瘤病会影响体内任何器官,但最常见的是影响你的肺、淋巴结、眼睛和皮肤。疾病的过程因人而异。
关键词:结节病、肺、淋巴结、肉芽肿性疾病
肉状瘤病是年代系统性肉芽肿性疾病,主要影响人体的肺和淋巴系统。这种疾病通常包括在肺中肉芽肿的形成。其他一般涉及的器官系统包括淋巴结、皮肤、心血管、眼睛,神经系统,肌肉骨骼、肾、内分泌系统。哈钦森在1877年首次描述肉状瘤的病例(1)。
肉状瘤病的病因尚不清楚。最近的报告显示高丙种球蛋白血症的细胞活动增加,迟发型过敏的降低,免疫失调都与肉状瘤病有关。遗传(HLA-B8 HLA-A1 HLA-DR3)以及环境因素也都是有关系的。常见的传染性病原体有结核分枝杆菌、支原体物种,棒状杆菌物种,螺旋体,非典型分枝杆菌,痤疮丙酸杆菌,伯氏疏螺旋体、单纯疱疹病毒、丙型肝炎病毒,巴尔病毒、巨细胞病毒、柯萨基病毒、风疹病毒、组织胞浆菌属物种,隐球菌物种,球孢子菌病,孢子丝菌病(2-3)。
Sarcoidosis is a disease of unknown cause that leads to inflammation.Sarcoidosis can affect virtually any organ,but most commonly it affects your lungs,lymph nodes,eyes and skin.The course of the disease varies from person to person.
Key Word:Sarcoidosis,Lungs,Lymph Node,Granulomatous disease
Sarcoidosis is s systemic granulomatous disease that primarily affects the lungs and lymphatic systems of the body.The disease most commonly involves granuloma formation in the lungs.Other commonly involved organ systems include the lymph nodes,dermatology,cardiovascular,opthalmology,nervous,musculoskeletal,renal,and endocrine systems.Hutchinson in 1877 first time described a case of sarcoid(1).
The etiology of sarcoidosis is unknown.Recent report have shown an increase in B-cell activity with hypergammaglobulinemia,reduced delayed-type hypersensitivity,immune dysregulation is responsible for sarcoidosis.Genetic(HLA-B8,HLA-A1,HLA-DR3)as well as environmental factors are also responsible.The common infectious agents implicated are Mycobacterium tuberculosis,Mycoplasma species,Corynebacteria species,spirochetes,atypical mycobacteria,Propionibacterium acnes,Borrelia burgdorferi,herpes simplex virus,hepatitis C virus,Epstein-Barr virus,cytomegalovirus,coxsackievirus,rubella virus,Histoplasma species,Cryptococcus species,coccidioidomycosis,and sporotrichosis(2-3).
Symptoms can appear suddenly and then just as quickly resolve spontaneously.Symptoms can be related to the specific organ affected,or non-specific general symptoms including:weight loss,loss of apetite,fatigue,fever,chills and night sweats.
Cutaneous involvement is seen in 25%of patients and usually accompanies systemic involvement.It is either specific or nonspecific.Erythema nodosum(EN)is the main nonspecific cutaneous disease;lupus pernio,maculopapular,nodular,scar,plaque,angiolupoid,ichthyosiform,lichenoid,psoriasiform,and ulcerative lesions and subcutaneous nodules are examples of specific cutaneous disease.EN is usually an acute,self-limiting process and rarely requires treatment.Tender,erythematous nodules are usually present on the extremities,most commonly on the anterior surface of the tibia.Lupus pernio is characterized by red-to-purple or violaceous,indurated plaques and nodules that usually affect the nose,the cheeks,the ears,and the lips,but it can appear on the dorsa of the hands,the fingers,the toes,and the forehead.Plaque sarcoidosis is characterized by round-to-oval,red-brown to purple infiltrated plaques;the center of the plaque may be atrophic.They most commonly occur on the extremities,the face,the scalp,the back,and the buttocks,and they may have an annular appearance.Subcutaneous nodular sarcoidosis is also called Darier-Roussy sarcoidosis.:Lesions are usually nontender,firm,oval,flesh-colored or violaceous nodules that are 0.5-2 cm in diameter.They are commonly found on the extremities or the trunk(3-5).
Pulmonary system:Respiratory symptoms involved in more than 90%of patients presents with coughing,shortness of breath,chest tightness or chest pain,hemoptysis,Clubbing and crackles.Parenchymal lung disease(larynx,trachea,bronchi)may lead to airway obstruction and bronchiectasis,airway hyperactivity.In 5%pleural effusion(Lymphocytic),chylothorax,pneumothorax,pleural thickening,lymph node calcification and cavity formation can occur.
