论文部分内容阅读
目的探讨肥大细胞增生症的临床病理学特点及诊断。方法对2例肥大细胞增生症进行临床资料分析、病理形态学观察、免疫表型和特殊染色检测。结果例1女婴,出生3个小时,出生时全身弥漫性皮疹,临床取腹部皮肤皮疹活检。例2男性,47岁,间断性腹泻7年,体检发现肝脾肿大,临床先后行结肠镜活检、骨髓穿刺活检和肝穿刺活检。组织形态学表现:例1皮肤真皮内有片状单核样细胞浸润。例2结肠黏膜内、骨髓内、肝窦及汇管区内见片状形态较一致的单核样细胞浸润,胞质较丰富,呈细颗粒状。免疫组化显示CD117和CD68(+),CD3、CD20、CD25、CD30、S-100和MPO(-)。甲苯胺蓝染色细胞胞质内见紫蓝色颗粒。结论肥大细胞增生症易误诊为其他白血病/淋巴瘤,以消化道症状为首发时常被误诊为炎症性肠病。利用特殊染色和免疫表型来证实肥大细胞对确定诊断十分重要。
Objective To investigate the clinicopathological features and diagnosis of mastocytosis. Methods Two cases of mastocytosis were analyzed by clinical data, pathomorphological observation, immunophenotype and special staining. Results Example 1 Baby girl, born 3 hours, a diffuse systemic rash at birth, and a clinically taken abdominal skin rash biopsy. Example 2 Male, 47 years old, intermittent diarrhea 7 years, physical examination found hepatosplenomegaly, clinical colonoscopy biopsy, bone marrow biopsy and liver biopsy. Histopathological findings: Example 1 There is sheet-like mononuclear cell infiltration in the dermis of the skin. Example 2 Colonic mucosa, bone marrow, sinusoidal and portal area see sheet-like morphology of monocyte-like cell infiltration, cytoplasm more abundant, was fine granular. Immunohistochemistry showed CD117 and CD68 (+), CD3, CD20, CD25, CD30, S-100 and MPO (-). Toluidine blue staining within the cytoplasm see purple blue particles. Conclusion Mast cell hyperplasia is often misdiagnosed as other leukemia / lymphoma. It is often misdiagnosed as inflammatory bowel disease with digestive symptoms as the starting point. The use of special stains and immunophenotypes to confirm mast cells is crucial for the diagnosis.