To study how to avoid delaying the diagnosis and misdiagnosis through the substantive cases analyzed retrospectively.
Selected the sarcoidosis cases involved from 1980 to now from the archive of our hospital, analyzed their clinical manifestations, radiographic presentations, lab examinations such as PPD test, SACE, pulmonary function test, urine calcium and sera-calcium, 67Ga lung scan, and the way to confirm diagnosis.
1,There were 125 female patients (63.1%) and 73 male patients(36.9%) with the average age of 35.1 years old. The average duration of the disease was 6.1 months and stage evaluation showed that there were 3, 86, 91 and 18 cases from stage 0 to 3 respectively. 2,35.4% of the cases were found by the physical examination, while other 64.6% by complaint of various symptoms such as cough, breathless, fever, chest pain. The main extrapulmonary manifestation was superficial lymph node enlargement, eyesight faintness, and skin lesions. 3,The usual presentation of the chest X-ray and CT was hilar and/or mediastinal lymph node enlargement accompanied with bilateral diffusion lesion or not. It was prone to make a wrong diagnosis and the rate of misdiagnosis is as high as 39.9%. 4,Among the various biopsy means, mediastinoscopy lymph node biopsy is the most valuable, and the superficial lymph nodes, skin nodus, bronchial mucous and transbronchial lung biopsy are worth recommending.
We should pay higher attention to sarcoidosis when the followings happen: middle-aged patients or young femalepatients; long duration of disease; mild respiratory tract symptoms accompanied with superficial lymph node enlargement or skin;eye involved; bilateral lung diffusion lesion in radiographic presentation accompanied with or without hilar, mediastinal lymphadenopathy. To avoid failing to diagnose or mistaking diagnosis, we should go all out to confirm the diagnosis through the tissue pathological examination .
The multifarious forms and presentations of Sarcoidosis and the low morbidity can make the diagnosis challenging, and it is prone to misdiagnosis in China.Through analyzing the cases respectively,we can learn more about this disease and enhance the diagnosis accurate rate.
Haiqing Chu, None.