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首页> 外文期刊>Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG >The value of labial biopsy in the differentiation of sarcoidosis from tuberculosis.
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The value of labial biopsy in the differentiation of sarcoidosis from tuberculosis.

机译：唇部活检在区分结节病和结核病中的价值。

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摘要

BACKGROUND: Since the clinical features of sarcoidosis and tuberculosis may mimic each other, and that differentiation is not easy on clinical grounds, a histologic diagnosis may be mandatory in countries where the prevalence of tuberculosis is high or in populations with large numbers of immigrants from those countries. Previous studies have suggested the minor salivary gland biopsy as a useful method in the diagnosis of sarcoidosis. The present study was undertaken to evaluate the value of labial biopsy in the differentiation of sarcoidosis from tuberculosis in patients with enlarged hilar and paratracheal lymph nodes. METHODS: Labial biopsy was performed in 50 consecutive patients with sarcoidosis, and in 35 consecutive patients with tuberculosis who had intrathoracic lympadenopathy. The files of all patients were reviewed for the clinical presentation, radiographic features, SACE levels, tuberculin skin test anergy, and the frequency of positive labial biopsy in each disease. RESULTS: Noncaseating granulomas were present in labial biopsies obtained from 24 patients (48%) of 50 patients with sarcoidosis. Labial biopsies were positive in 4 of 6 patients who had an abnormality on eye examination and in 3 of 5 patients who had noncaseating granulomas on biopsy material from skin. In two of 4 patients who underwent mediastinoscopy, noncaseating granulomas were detected on labial biopsy. In contrast to the patients with sarcoidosis labial biopsies revealed normal minor salivary glands in all patients with tuberculosis. CONCLUSIONS: Labial biopsy has a high discriminatory value as a diagnostic tool in the differentiation of sarcoidosis from tuberculosis. Although it has a rather lower diagnostic yield than transbronchial lung biopsy, labial biopsy should be considered as a first line approach prior to performing other more invasive procedures for the tissue confirmation of sarcoidosis.
机译：背景：结节病和结核病的临床特征可能相互模仿，并且根据临床原因很难区分，因此在结核病高发国家或大量移民的国家中，必须进行组织学诊断国家。先前的研究表明，唾液腺轻度活检可作为结节病诊断的有用方法。本研究旨在评估唇部活检对肺门和气管旁淋巴结肿大患者结节病与结核病鉴别的价值。方法：对50例结节病患者和35例患有胸腔内淋巴结病的结核病患者进行了唇部活检。审查所有患者的档案，以了解每种疾病的临床表现，影像学特征，SACE水平，结核菌素皮肤试验无反应性以及阴唇活检阳性的频率。结果：从50例结节病患者中的24例（48％）获得的阴唇活检组织中存在非干酪性肉芽肿。眼部检查异常的6例患者中有4例的阴唇活检为阳性，皮肤活检材料中有5例为非干酪性肉芽肿的患者中有3例为阴唇活检。在接受纵隔镜检查的4例患者中，有2例在阴唇活检中发现了非干酪性肉芽肿。与结节病患者相反，所有组织结核患者的唇部活检均显示正常的小唾液腺。结论：唇部活检作为鉴别结节病和结核病的诊断工具具有很高的鉴别价值。尽管与经支气管肺活检相比，它的诊断率要低得多，但在进行其他更具侵入性的过程以确认结节病之前，应将唇部活检视为一线方法。

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