软斑病4例临床病理及误漏诊分析
发布时间：2019-03-26 10:28
【摘要】：目的:提高对软斑病(malakoplakia)的发病机制、临床病理学特征的认识及诊疗水平,避免误诊、漏诊。方法:收集山西省肿瘤医院2007年3月至2017年3月诊断为软斑病4例患者的临床资料,观察其组织病理学形态,行免疫组织化学及特殊染色。4例患者平均发病年龄为63(56~76)岁。其中男性2例、女性2例,发生于膀胱2例、双侧输尿管1例、右侧盆腔1例。1例有糖尿病史患者合并系统性红斑狼疮,另3例无特殊疾病史。结果:4例患者的病变组织学形态均显示大量片状分布的组织细胞、同心圆状排列的嗜碱性Michaelis-Gutmann(M-G)小体、淋巴细胞、浆细胞、嗜酸性粒细胞及中性粒细胞浸润。免疫组织化学法显示组织细胞PGM-1及CD68阳性。钙、铁染色及PAS染色中M-G小体均阳性。结论:软斑病是一种罕见肉芽肿性病变,可在多个器官形成瘤样结节。多累及泌尿生殖系统,但在身体各器官均可发生。无特异性的临床表现,影像学多表现为占位性病变,因此极易被临床误诊为恶性病变。确诊主要依靠病理诊断,因其罕见性致使病理工作者易漏诊,其中特殊染色方法对诊断具有较大的帮助。
[Abstract]:Objective: to improve the understanding of pathogenesis, clinicopathological features and diagnosis and treatment of soft spot disease (malakoplakia) in order to avoid misdiagnosis and missed diagnosis. Methods: the clinical data of 4 patients diagnosed as soft spot from March 2007 to March 2017 in Shanxi Cancer Hospital were collected and their histopathological features were observed. The average age of onset was 63 (56 / 76) years. Among them, 2 cases were male, 2 cases were female, 2 cases occurred in bladder, 1 case was bilateral ureter, 1 case was right pelvis, 1 case had diabetic history with systemic lupus erythematosus (SLE), and the other 3 cases had no history of special diseases. Results: all the 4 patients showed a large number of patchy tissue cells, concentric round arrangement of basophilic Michaelis-Gutmann bodies, lymphocytes, plasmacytes, eosinophils and neutrophils. Immunohistochemical staining showed that PGM-1 and CD68 were positive in tissue cells. M + G bodies were positive in calcium, iron and PAS staining. Conclusion: soft spot is a rare granulomatous lesion that can form tumor-like nodules in multiple organs. Multiple involvement in the genitourinary system, but can occur in all organs of the body. It is easy to be misdiagnosed as malignant lesion because of its non-specific clinical manifestation and space-occupying lesions. The diagnosis mainly depends on pathological diagnosis. Because of its rarity, pathologists are easy to miss diagnosis, among which the special staining method is of great help in diagnosis.
【作者单位】： 山西省肿瘤医院病理科;
【分类号】：R593.9
本文编号：2447457
[Abstract]:Objective: to improve the understanding of pathogenesis, clinicopathological features and diagnosis and treatment of soft spot disease (malakoplakia) in order to avoid misdiagnosis and missed diagnosis. Methods: the clinical data of 4 patients diagnosed as soft spot from March 2007 to March 2017 in Shanxi Cancer Hospital were collected and their histopathological features were observed. The average age of onset was 63 (56 / 76) years. Among them, 2 cases were male, 2 cases were female, 2 cases occurred in bladder, 1 case was bilateral ureter, 1 case was right pelvis, 1 case had diabetic history with systemic lupus erythematosus (SLE), and the other 3 cases had no history of special diseases. Results: all the 4 patients showed a large number of patchy tissue cells, concentric round arrangement of basophilic Michaelis-Gutmann bodies, lymphocytes, plasmacytes, eosinophils and neutrophils. Immunohistochemical staining showed that PGM-1 and CD68 were positive in tissue cells. M + G bodies were positive in calcium, iron and PAS staining. Conclusion: soft spot is a rare granulomatous lesion that can form tumor-like nodules in multiple organs. Multiple involvement in the genitourinary system, but can occur in all organs of the body. It is easy to be misdiagnosed as malignant lesion because of its non-specific clinical manifestation and space-occupying lesions. The diagnosis mainly depends on pathological diagnosis. Because of its rarity, pathologists are easy to miss diagnosis, among which the special staining method is of great help in diagnosis.
【作者单位】： 山西省肿瘤医院病理科;
【分类号】：R593.9
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1 马鸿达;张乃鑫;;软斑病二例报告[J];天津医药;1990年05期
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