肠道贝赫切特综合征的临床病理Clinicopathological Findings of Intestinal Behcet Syndrome
肖雨;周炜洵;王维斌;梁智勇;刘彤华;
XIAO Yu1,ZHOU Wei-xun1,WANG Wei-bin2,LIANG Zhi-yong1,LIU Tong-hua1 1Department of Pathology,2Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China
摘要(Abstract):
目的观察肠道贝赫切特综合征(Behcet syndrome,BS,又称白塞病)的临床病理学表现,建立肠道BS初步的病理诊断标准。方法采用传统组织病理学观察方法,对北京协和医院收治的行回结肠切除术的2例肠道BS标本进行肉眼观察及HE染色切片显微镜下观察。结果两例肠道BS标本共同的临床病理学特点是:(1)均符合国际公认的BS诊断标准;(2)均由于难治性肠道出血行手术切除;(3)肠道溃疡均位于回盲部,多发性,垂直于肠腔长轴,溃疡周围黏膜水肿;(4)显微镜下均可观察到溃疡下方非坏死性小血管炎。结论肠道BS需要在系统性BS确诊或高度可疑情况下除外其他疾病后,结合典型的结肠镜和显微镜下表现作出诊断。
Objective To observe the clinicopathological features of intestinal Behcet syndrome(BS).Methods The ileocolonic resections obtained from two patients with intestinal BS in Peking Union Medical College Hospital were reviewed with naked eyes and microscope.Their clinical features were also summarized.Result The common clinicopathological findings included:met the internationally recognized BS diagnostic criteria;ileocolonic resection was performed due to refractory intestinal bleeding;the intestinal ulcers,located within the ileocecal junction,were multifocal,perpendicular to the long axis of the intestine,and with adjacent mucosa became swollen;non-necrotizing vasculitis beneath the ulcers was found under microscope.Conclusion BS may be diagnosed based on its typical clinicopathological findings after other diseases are carefully excluded.
关键词(KeyWords):
肠道贝赫切特综合征;炎性肠病;病理诊断
intestinal Behcet syndrome;inflammatory bowel disease;pathological diagnosis
基金项目(Foundation):
作者(Author):
肖雨;周炜洵;王维斌;梁智勇;刘彤华;
XIAO Yu1,ZHOU Wei-xun1,WANG Wei-bin2,LIANG Zhi-yong1,LIU Tong-hua1 1Department of Pathology,2Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China
Email:
DOI:
参考文献(References):
- [1]Oshima Y,Shimizu T,Yokohari R,et al.Clinical studies on Behcet's syndrome[J].Ann Rheum Dis,1963,22:3645.
- [2]Kasahara Y,Tanaka S,Nishino M,etal.Intestinalinvolvement in Behcet's disease:review of136surgical cases in the Japanese literature[J].Dis Colon Rectum,1981,24:103106.
- [3]Masugi J,Matsui T,Fujimori T,et al.A case of Behcet's disease with multiple longitudinal ulcers all over the colon[J].Am J Gastroenterol,1994,89:778-780.
- [4]International Study Group for Behcet's Disease.Criteria for diagnosis of Behcet's disease[J].Lancet,1990,335:1078-1080.
- [5]Kaklamani VG,Vaiopoulos G,Kaklamanis PG.Behcet's disease[J].Semin Arthritis Rheum,1998,27:197-217.
- [6]Chajet ST,Pisarity S,Knobler H,et al.HLA-B51may serve as an immunogenetic marker for a subgroup of patients with Behcet's syndrome[J].Am J Med,1987,83:666672.
- [7]Cheon JH,Kim ES,Shin SJ,et al.Development and validation of novel diagnostic criteria for intestinal Behet's disease in Korean patients with ileocolonic ulcers[J].Am J Gastroenterol,2009,104:2492-2499.
- [8]Smith J,Siddiqui D.Intestinal Behcet's disease presenting as a massive acute lower gastrointestinal bleed[J].Digest Dis Sci,2002,47:517-521.
- [9]王维斌,赵玉沛,丛林,等.19例胃肠型白塞病误诊误治分析[J].腹部外科,2010,23:338-340.
- [10]Yoon SJ,Jin YY,Jin HL,et al.Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcet's disease[J].Inflamm Bowel Dis,2011,17:1594-1602.
- 肖雨
- 周炜洵
- 王维斌
- 梁智勇
- 刘彤华
XIAO Yu1- ZHOU Wei-xun1
- WANG Wei-bin2
- LIANG Zhi-yong1
- LIU Tong-hua1 1Department of Pathology
- 2Department of General Surgery
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College
- Beijing 100730
- China
- 肖雨
- 周炜洵
- 王维斌
- 梁智勇
- 刘彤华
XIAO Yu1- ZHOU Wei-xun1
- WANG Wei-bin2
- LIANG Zhi-yong1
- LIU Tong-hua1 1Department of Pathology
- 2Department of General Surgery
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College
- Beijing 100730
- China