| 谢晨,马天文,林国成,等.多系统性结节病 1例的多学科诊疗实践[J].安徽医药,2026,30(9):1817-1820. |
| 多系统性结节病 1例的多学科诊疗实践 |
| MDT diagnosis and treatment practice of a case of multiple systemic sarcoidosis |
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| DOI：10.3969/j.issn.1009-6469.2026.09.022 |
| 中文关键词: 结节病 肺部结节 多系统 多学科诊疗 肉芽肿性炎 住培学员 |
| 英文关键词: Sarcoidosis Pulmonary nodules Multisystem Multi-disciplinary team Granulomatous inflammation Residen. tial training students |
| 基金项目:湖北省卫生健康委临床医学教育教学改革研究项目( HBJG-220031) |
| 作者 | 单位 | E-mail | | 谢晨 | 宜昌市第二人民医院,放射科,湖北宜昌 443000 | | | 马天文 | 宜昌市第二人民医院,放射科,湖北宜昌 443000 | | | 林国成 | 宜昌市第二人民医院,放射科,湖北宜昌 443000 | 13574895@qq.com | | 曾天星 | 宜昌市第二人民医院,呼吸科,湖北宜昌 443000 | | | 徐弘 | 宜昌市第二人民医院,病理科,湖北宜昌 443000 | | | 张帅 | 宜昌市第二人民医院,肝胆外科,湖北宜昌 443000 | | | 龙勇 | 宜昌市第二人民医院,皮肤科,湖北宜昌 443000 | | | 丁霑 | 宜昌市第二人民医院,风湿免疫科,湖北宜昌 443000 | |
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| 中文摘要: |
| 目的报告 1例累及多系统的结节病的多学科诊疗( MDT)实践。方法回顾性分析宜昌市第二人民医院 2023年 2月收治的 1例累及肝、肺、脾脏及皮肤的结节病 MDT经过，包括呼吸科、放射科、肝胆外科、病理科、皮肤科以及风湿免疫科的 MDT团队，对病人病情及治疗进行分析、讨论，全体住培学员也同时参加会议。结果女， 59岁，咳嗽 2个月，外院诊断肺部恶性肿瘤并肝脏及脾脏多发转移，病人行肝脏及肺部穿刺提示肉芽肿性炎，经支气管镜下肺活检提示肉芽肿性炎，结核检查排除结核，经该院 MDT考虑结节病。给予激素治疗 1个月后复查肺部病灶较前缩小，肝脏、脾脏病灶完全吸收，激素减量 3个月后复查肺部病灶进展，按照结节病复发治疗，治疗后复查病灶稳定，随访至 2024年 8月病人病灶未见进展。结论结节病表现复杂，容易误诊为肿瘤， MDT明确病因，同时也提高了住培学员对结节病累及多系统的认识。 |
| 英文摘要: |
| Objective To report the practice of multi-disciplinary team (MDT) diagnosis and treatment in one patient with multisys. tem sarcoidosis.Methods A retrospective analysis was conducted on the MDT diagnosis and treatment process of a case of sarcoidosisinvolving the liver, lungs, and spleen, who was admitted to Yichang Second People's Hospital in February 2023. The MDT team consist.ing of specialists from the department of respiratory medicine, department of radiology, department of hepatobiliary surgery, departmentof pathology, department of dermatology and department of rheumatology and immunology analyzed and discussed the patient's condi.tion and treatment, with all resident trainees participating in the MDT meeting simultaneously.Results The 59-year-old female patient presented with a 2-month cough and was misdiagnosed as malignant lung tumor complicated with multiple metastases of the liver andspleen in another hospital. Liver biopsy, lung biopsy and transbronchial lung biopsy all indicated granulomatous inflammation, and tu.berculosis tests ruled out tuberculosis infection. The patient was diagnosed with sarcoidosis after MDT discussion. After one month ofglucocorticoid therapy, reexamination showed that pulmonary lesions shrank while hepatic and splenic lesions were completely ab.sorbed. Three months after glucocorticoid tapering, pulmonary lesions progressed, and the patient received targeted treatment for recur.rent sarcoidosis. The lesions remained stable after treatment, and no lesion progression was observed during follow-up until August 2024.Conclusion Sarcoidosis has complicated clinical manifestations and is easily misdiagnosed as malignant tumors. MDT can clari.fy the etiology of the disease, and meanwhile improve resident trainees' understanding of multisystem involvement of sarcoidosis. |
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