Lymph node sarcoidosis

Introduction to lymph node sarcoidosis Sarcoidosis is a chronic granulomatous disease of the lymphatic network. The cause is unknown. It is generally considered to be an abnormal manifestation of immune response. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: osteoarthritis

Causes of lymph node sarcoidosis

The cause is still unknown. Due to the occasional fever in the course of the disease and the incidence of more than one person in the family at the same time, it was suspected to be caused by the infection, but was not found.

Pathogens. The body fluid immunity is normal or enhanced, and IgM, IgA and IgG are increased. These phenomena suggest that the cellular immune function of the sick child is low.

The pathological feature is chronic granulomatous inflammation without dry necrosis, similar to granulomatosis caused by fungal diseases such as histoplasmosis, leprosy or tuberculosis. The main organs that are invaded are lining, lungs, skin, eyes and bones, especially the bones of the hands and feet. Most of the miliary granuloma is visible in the diseased organs. From a few millimeters to 1-2 centimeters, like tuberculous granuloma. Epithelioid cells and a number of multinucleated giant cells with a radial arrangement are visible in the center of the lesion.

Lymph node sarcoidosis, also known as sarcoma-like disease, is an unidentified, chronic, non-caseous epithelioid granulomatous lesion that can affect a wide variety of organs throughout the body. Symptoms are less obvious, progress is slow, and remission and recurrence occur alternately. , can last for many years.

Lymph node nodule prevention

In the case of lymph node sarcoidosis, the first step is to go to the hospital to check the specific parts and what kind of bacteria are caused, so that more effective and targeted treatment can be carried out.

Lymph node sarcoidosis complications Complications osteoarthritis

Osteoarthritis

Symptoms of lymph node sarcoidosis Common symptoms Unexplained fever, night sweats, anorexia, tiredness

Symptoms vary greatly depending on the organ involved. Slow onset, often lack of systemic symptoms such as fever, anorexia, night sweats and fatigue, or only occasionally.

1. Lymph node enlargement. In addition to mediastinal lymphadenopathy, there may be superficial lymph nodes, no tenderness, no adhesions. The liver and spleen are enlarged, and the parotid gland enlargement is a prominent symptom.

2. Rash. About one-third of patients have special skin changes, showing a variety of sarcomatoid granulomas, more common in the face. The rash may be waxy miliary nodules or larger papules, and some may be drenched, raised or flat smooth purple-red rash or papules. The diameter may be more than 1 cm. Nodular erythema is also common, an early symptom of this disease. The rash can appear itching.

3. Eye symptoms. Keratitis, iritis, iridocyclitis, uveitis and glaucoma are more common. Occasionally retinitis or retinal hemorrhage. The lacrimal gland is invaded and may have symptoms such as sweating. Eventually, it can cause fibrosis of the phlegm film and cause visual impairment.

4. Salivary glands are swollen. It is a painless enlargement of the parotid gland and other salivary glands, combined with uveitis, facial paralysis and fever.

5. Pulmonary lesions. Lymph nodes around the hilar and trachea are enlarged, and miliary nodules or reticular shadows can be seen in the lung fields. When the granuloma is swollen in the alveoli, the lungs may have a flocculent shadow. Occasionally symptoms of cough and chest pain.

6. Skeletal and joint lesions. Skeletal changes are more common in the hands and feet, mild pain and dyskinesia. X-ray films showed multiple cystic changes, joint synovial thickening, and key sheath involvement.

Examination of lymph node sarcoidosis

In most patients, plasma and Y globulin increased the ratio of albumin to globulin, and blood calcium increased. There were no other blood changes except for the increase in eosinophils. ESR can increase.

According to clinical symptoms and X-ray examination, tissue biopsies such as surrounding lymph nodes and rash should be done when suspicious. Taking a knotted knot disease from a confirmed nodule patient

Tissue, the reaction can occur 1 week after injection, peak at 4-6 weeks, local red papules, can gradually increase to 3-8mm. At this time, a local tissue biopsy was taken, and the nodular degeneration was observed.

Diagnosis and differentiation of lymph node sarcoidosis

Differential diagnosis of lymph node sarcoidosis

Lymph node sarcoidosis should be distinguished from tuberculosis. Van Den Oord et al (1984) studied 4 cases of sarcoidosis lymphadenitis and 5 cases of tuberculous lymphadenitis, and found that the cells composed of the two were similar. The center is OKM1-positive epidermal-like tissue cells and multinucleated giant cells, and a few are composed of OKT4-positive helper T cells and many OKT8-positive suppressor T cells. There is no B lymphocyte in the central part. However, the coat of nodules is B-positive B lymphocytes. There is a circular distribution of positive suppressor T lymphocytes between the nodules and the sleeve. But according to the HE slice combined with other checks, the two can be distinguished by the following points:

1 Nodules are small and scattered, unlike tuberculous nodules that fuse into larger lesions, and epithelial nodules involve more than one organ.

2 There are few multinuclear giant cells, and the nucleus is dispersed in the cytoplasm.

There is no lymphocytic infiltration around the nodules, often fibrosis, and the surrounding boundary is clear.

4 no cheese-like necrosis occurred.

5 angiotensin-transferase (ACE) positive in epithelial cells of sarcoidosis [Pertscnuk et al. (1981)]

The 6Kveim Siltzbach test was positive, and the granuloma reaction occurred at the inoculation site by intradermal injection of the antigen prepared by the known sarcoidosis tissue. However, such tests can also be found in tuberculosis, histoplasmosis, globosporosis and Crohn's disease.

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