UNASSIGNED: Single case report and narrative review.
UNASSIGNED: A 59-year-old male patient presented with a year-long history of diminished vision and weight loss. Clinical examination revealed panuveitis and multiple chorioretinal lesions. A CT scan of the chest revealed mediastinal and hilar lymphadenopathy as well as a spiculated right lower lung nodule concerning for malignancy. Subsequent bronchoscopy and biopsy confirmed lung adenocarcinoma and non-caseating granulomas in sentinel lymph nodes.
UNASSIGNED: Although pulmonary granulomatous reaction can be seen in the setting of lung malignancy, and ocular sarcoid-like reaction may present as a paraneoplastic manifestation of systemic malignancy, the presence of concomitant pulmonary and ocular sarcoid-like reactions distinguishes this case. The findings underscore the importance of a systemic workup for patients with concerning constitutional symptoms, as paraneoplastic syndromes and metastatic diseases may mimic uveitis. Recognition of paraneoplastic sarcoidosis as a potential clinical manifestation is essential, especially in patients with chronic illness indicators, necessitating a comprehensive evaluation for malignancy.
■单例报告和叙述性回顾。
■一名59岁的男性患者,有一年的视力下降和体重减轻的病史。临床检查显示全葡萄膜炎和多发性脉络膜视网膜病变。胸部CT扫描显示纵隔和肺门淋巴结肿大以及恶性的右下肺结节。随后的支气管镜检查和活检证实前哨淋巴结中有肺腺癌和非干酪性肉芽肿。
■尽管肺肉芽肿反应可以在肺部恶性肿瘤中看到,眼部类肉瘤样反应可能表现为系统性恶性肿瘤的副肿瘤表现,伴随的肺和眼部类肉瘤样反应的存在区分了这种情况。这些发现强调了对有体质症状的患者进行系统性检查的重要性,因为副肿瘤综合征和转移性疾病可能模拟葡萄膜炎。识别副肿瘤结节病作为潜在的临床表现是至关重要的,尤其是有慢性病指标的患者,需要对恶性肿瘤进行全面评估。