52例囊虫性脑小脓肿的病理观察

PATHOLOGICAL OBSERVATIONS ON 52 CASES WITH CYSTICERCOTIC SMALL ENCEPHALO-PYOSIS

对52例因癫痫发作就诊,CT检查在脑内发现小脓肿的病例,手术切除标本进行了寄生虫学检查,证实为脑囊虫病患者。取脓肿壁作病理切片,病理检查发现5例囊虫仍存活并伸出头节,16例囊虫虽死亡但虫体尚完整,14例在切片中查见了虫体成分。结果表明病变组织的坏死和炎症反应以完整死虫组最显著;至囊虫残破炎症逐渐缓和,增生性变化渐占优势,脓肿腔缩小;有3例硬结纤维化;钙质沉积罕见。对脑内囊虫性小脓肿的形成以及病变与CT影像之间的相关性进行了讨论。

The pathological examination of 52 cases of cysticercotic cerebral abscess was re- ported. The living cysticerci in brain were found in 5 cases, the dead larvae with their cysts were seen in 16 cases and the cysticercus wreckages were recognizable in 14 cases in the sections. Ac- cording to the active states of the larvae, the lesions were divided into living worm group, dead worm group with intact cyst and wrecked group. In comprision among these groups, it was found that there existed a strongest inflammatory reaction and severest necrosis in the group of dead worms with cysts. When the larvae disrupted, the inflammation tended to be weak, proliferation gradually took advantage, and finally the abscess cavity shrinked or formed a hard fibrous nod- ule, but calcification was rare. In this paper, the formation of cysticrcotic cerebral abscess and the correlations between the lesions and CT image were also discussed and a detail description of the calcareous corpuscles was presented so as to make the pathogenesy of the lesions clear.