同性恋者梅毒性直肠炎2例临床病理分析

Syphilitic proctitis in homosexual men: a report of 2 cases and review of literature

目的 分析同性恋者梅毒性直肠炎的组织病理学特点及临床表现。方法 对 2例具有肠道症状的同性恋者梅毒性直肠炎临床表现、病理形态学特点进行探讨。结果 2例同性恋者梅毒性直肠炎镜下具有梅毒病变的基本组织学特点 ,表现为淋巴细胞和浆细胞浸润构成的非特异性炎、闭塞性动脉内膜炎和血管周围炎 ;血清学检测梅毒螺旋体抗体阳性表达。结论同性恋者梅毒性直肠炎临床表现常无特殊性 ,组织学检查浆细胞恒定浸润是本病的特征性改变之一。梅毒性直肠炎既易于合并其他病原菌感染 ,又常易被误诊为其他肠道病变。在了解病史的基础上 ,根据其组织学特点 ,结合血清学检测结果 ,可以做出明确的病理诊断。

Purpose To investigate clinicopathologic features of the syphilitic proctitis in homosexual patients. Methods Clinical data and pathological features of the syphilitic proctitis are evaluated retrospectively in 2 cases. Histopathologic changes, immunohistochemical findings and serological examination were analyzed. Results The syphilitic proctitis had basic syphilitic histopathologic features, which demonstrated markedly hyperplastic blood vessels surrounded by a lymphoplasmacytic infiltrate. The serological examination shows the blood was positive for TPHA. Conclusions Clinical data of the syphilitic proctitis often has no characteristics. Pathological features exhibit diffuse infiltrate prominently composed of plasma cells. The syphilitic proctitis always exist the other pathogens infection and is thus easily misdiagnosed. Correct diagnoses must be according as histopathologic changes, clinical findings and serological examination.