摘要
目的探讨肠道荚膜组织胞浆菌病的临床病理特征、诊断与鉴别诊断。方法对2例发生于肠道的组织胞浆菌病进行临床病理学、特殊染色和电镜观察,并复习相关文献。结果 2例患者均为男性,年龄为47岁和68岁。病变部位均为回肠黏膜固有层和黏膜下层;组织细胞内外可以见到组织胞浆菌孢子,PAM和PSA染色均为(+);电镜下组织胞浆菌有分层的荚膜和高电子密度的染色质。2例经抗组织胞浆菌治疗后好转出院。结论肠道组织胞浆菌病多由播散性组织胞浆菌病累及所致,好发于淋巴组织丰富的回肠。病理诊断主要靠光镜检查见真菌孢子,PAM和PAS染色均(+)。电镜检查也有诊断价值。大部分患者可以治愈,少数免疫缺陷患者可导致死亡。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of intestinal histoplasmosis （IHP）. Methods Two cases of IHP were studied by means of clinicopathologic data analysis, HE stain, histoehemical staining and electromicroscopy. In addition, the related literature was reviewed. Results Two patients were male, aged 47 and 68 years old. The region of disease was located in the lamina propria mucosae and submucous of ileum. Histologically, the histoplasma was found in and out of histocyte. PAS and PAM staining were positive in 2 cases. Both cases were recovered well by anti-histoplasma therapy. Conclusions Intestinal histoplasmosis is usually caused by progressive disseminated histoplasmosis （PDH）. Intestinal involvement is most common, particularly the terminal ileum with abundant lymphoid tissue. The pathological diagnosis of intestinal histoplasmosis depends on the detection by the microscope and special staining. Electron microscope is a valuable tool in clinical diagnosis. Most patients can be treated well, but some with immune deficiency may die.
出处
《诊断病理学杂志》
CSCD
北大核心
2013年第9期549-552,共4页
Chinese Journal of Diagnostic Pathology
