What are the clinical manifestations of pulmonary nodules?

The symptoms and signs of pulmonary nodules vary according to the sequence of onset and the number of organs involved. Chest sarcoidosis often has no obvious symptoms and signs in the early stage, sometimes coughing, coughing a little sputum, and occasionally seeing a little hemoptysis; There may be fatigue, fever, night sweats, loss of appetite and weight loss.

When the lesions are extensive, chest tightness, shortness of breath and even cyanosis may occur. It can be aggravated by infection, emphysema, bronchiectasis and pulmonary heart disease. If sarcoidosis involves other organs at the same time, corresponding symptoms and signs may appear. For example, erythema nodosum is the most common skin, which is more common on the face, neck, shoulders or limbs. There are also lupus erythematosus, macula, papules and so on. Sometimes subcutaneous nodules are found. Invasion of the scalp can lead to hair loss.

About 30% patients will have skin damage. The cases of eye damage are about 15%, including iridocyclitis, acute uveitis and keratoconjunctivitis. Eye pain, blurred vision and congestion of ciliary body may occur. Some patients have hepatomegaly and/or splenomegaly, bilirubin and alkaline phosphatase are slightly increased, or liver function is damaged.

Mediastinum and superficial lymph nodes are often invaded and enlarged. If joints, bones and muscles are involved, polyarthritis may occur. X-ray examination shows multiple small cystic bone defects (bone cysts) in short bones of limbs and hands and feet. Muscle granuloma can cause local swelling and pain. About 50% cases involve the nervous system, and its symptoms are varied.

There may be cerebral palsy, neuromuscular diseases, brain occupying lesions, meningitis and other clinical manifestations. When sarcoidosis involves myocardium, arrhythmia or even heart failure may occur, and about 5% cases involve the heart. Pericardial effusion may also occur. Sarcoidosis can interfere with calcium metabolism, lead to the increase of blood calcium and urine calcium, and cause calcium deposition in kidney and kidney calculi.

Diabetes insipidus can be caused when pituitary gland is involved, and hypergalactosemia and serum prolactin can occur when hypothalamus is involved. When parotid gland, tonsil, larynx, thyroid gland, adrenal gland, pancreas, stomach and reproductive system are involved, it can cause related symptoms and signs, but it is rare. Sarcoidosis can involve one organ or multiple organs at the same time.

Extended data

Pathogenesis of pulmonary nodules;

Sarcoidosis is the result of competition between unknown antigen and cellular immunity and humoral immunity. Due to the adjustment of individual differences (age, sex, race, genetic factors, hormones, HLA) and antibody immune response, the development and regression of granuloma are determined by the imbalance of promoting factors and antagonistic factors produced by it, showing different pathological States and natural remission trends of sarcoidosis.

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