83例胸内结节病临床特征及诊断方法分析

目的：探讨胸内结节病的临床特征及诊断方法,尤其是支气管镜检查在胸内结节病诊断中的应用价值。方法：总结2000年3月至2009年7月在上海长海医院住院的83例胸内结节病患者的临床资料,分析其实验室检查及病理活组织检查（活检）方法的特点。结果：①患者症状具有多样性,胸部影像学检查是早期诊断的重要手段;②确诊依赖组织病理学检查;③经支气管镜活检及经纵隔镜淋巴结活检诊断阳性率较高。结论：结节病的临床表现无特异性,明确诊断需结合各项检查结果综合分析。对有肺门、纵隔淋巴结肿大的可疑病例,应尽可能做组织病理学检查以明确诊断。

Clinical features and diagnosis of intrathoracic sarcoidosis: analysis of 83 cases

Objective To analyze the clinical features and diagnosis of intrathoracic sarcoidosis and to evaluate the diagnostic value of bronchoscopy.Methods The clinical feature,laboratory examination and pathological diagnosis of 83 cases of intrathoracic sarcoidosis hospitalized from March 2000 to July 2009 were analyzed retrospectively.Results ① Symptoms were variable and chest imaging was the major approach for early diagnosis of the disease.② Established diagnosis depended on histopathology.③ Bronchoscopic biopsy and transmediastinoscopic lymph node biopsy had high positive diagnostic rate.Conclusions The clinical feature of sarcoidosis was not specific and diagnosis should be made on the basis of comprehensive analysis of clinical manifestations and laboratory examinations.In suspected cases with hilar and mediastinal lymph node enlargement,biopsy examination should be performed for establishing the diagnosis.