内镜活检Crohn病的临床病理分析

doi:10.3969/j.issn.1000-8535.2019.01.013

广州医药 ›› 2019, Vol. 50 ›› Issue (1): 52-56.DOI: 10.3969/j.issn.1000-8535.2019.01.013

内镜活检Crohn病的临床病理分析

黄薇¹, 杨通¹, 关晓颖²

1 广州医科大学附属第二医院病理科（广州 510260）;
2 广州医科大学基础医学院生物医学工程（广州 511436)

收稿日期:2018-09-07 出版日期:2019-01-20 发布日期:2021-12-21

Endoscopic biopsy of Crohn's disease：a clinicopathological Study

HUANG Wei¹, YANG Tong¹, GUAN Xiaoying²

1 Department of Pathology,The Second Affiliated Hospital,Guangzhou Medical University,Guangzhou 510260,China;
2 Department of Biomedical Engineering, Basic Medicine School, Guangzhou Medical University, Guangzhou 511436,China

Received:2018-09-07 Online:2019-01-20 Published:2021-12-21

摘要/Abstract

摘要： 目的探讨内镜活检Crohn病（CD）的临床病理特征,为临床提供更可靠的诊断。方法回顾性分析内镜活检12例CD的临床表现、内窥镜特征,采用HE染色及免疫组化EnVision二步法。结果显微镜下CD的组织学形态主要特征是非干酪样坏死性肉芽肿、裂隙状溃疡、黏膜及黏膜下层不均匀分布的重度炎症,淋巴管扩张和纤维组织增生,免疫组化染色CD68、D2-40、S-100均表达。结论 CD是一肿少见的炎症性肠病,回盲部及末段回肠是最好发部位,主要表现反复腹泻、血便等症状,内镜下见多灶溃疡,不连续性病变等特征,组织学见裂隙性溃疡,黏膜及黏膜下层的重度炎症且不均匀分布,位于生发中心的非干酪结节病样肉芽肿、淋巴管扩张和纤维组织增生等非特异性特征,可靠的病理诊断要结合临床、内镜、影像等检查及多部位多次活检。

关键词: Crohn病, 内镜活检, 肉芽肿, 裂隙状溃疡, 免疫组织化学

Abstract: Objective To investigate the clinical and pathological features of endoscopic biopsy tissue of Crohn disease （CD） and further to provide more reliable evidence for clinic. Methods A retrospective analysis of 12 cases of endoscopic biopsy tissue about CD’s clinical manifestations and endoscopic features,by HE staining and immunohistochemistry EnVision two-step method. Results The morphology of CD specimen is characterized by non-caseous necrotizing granuloma,ulceration,mucosal and submucosal uneven distribution of severe inflammation,dilated lymph vessels and fibrous hyperplasia. Immunohistochemical staining , all of cases express CD68,D2-40 and S-100. Conclusion CD is a rare inflammatory bowel disease. The majority of CD arises in ileocecal and terminal ileum. The main symptoms show repeated diarrhea,bloody stool and others. Endoscopic examination revealed multifocal ulcers,discontinuous lesions and other characteristics. Histological examination showed that there were nonspecific features such as fissure ulcer,severe inflammation in mucosa and submucosa with uneven distribution,non-caseous sarcoid-like granuloma in the germinal center,lymphangiectasis and fibrous tissue hyperplasia. An reliable pathological diagnosis is made that depends on many examinations including clinical,endoscope,radiology and multiple biopsy.

Key words: Crohn disease, Endoscopy biopsy, Granuloma, Fissure ulcer, Immunohistochemistry

黄薇, 杨通, 关晓颖. 内镜活检Crohn病的临床病理分析[J]. 广州医药, 2019, 50(1): 52-56.

HUANG Wei, YANG Tong, GUAN Xiaoying. Endoscopic biopsy of Crohn's disease：a clinicopathological Study[J]. Guangzhou Medical Journal, 2019, 50(1): 52-56.

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内镜活检Crohn病的临床病理分析

Endoscopic biopsy of Crohn's disease：a clinicopathological Study

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