阑尾结核15例临床病理观察

Aclinicopathologicalobservationof15casesoftuberculosisoftheappendix

目的探讨阑尾结核的临床病理特征和诊断。方法对１９５９～１９９５年间，从５６２１例阑尾病理检查标本中检出的１５例（占０．２７％）阑尾结核作回顾性分析。结果阑尾结核以青年人（≤３４岁者共１２例）和女性（共１１例）多见，常继发于腹腔其它部位结核。显微镜下发现增殖型１１例，溃疡型４例。临床误诊的１４例（９３％），与慢性阑尾炎、回盲部结核或肿瘤、阑尾的癌瘤等不易鉴别。结论阑尾结核的确诊主要靠病理检查。建议临床医师对所有切除的阑尾，无论肉眼观察是否正常，都应作病理检查，以防误诊或漏诊。

ObjectiveTostudytheclinicopathologicalfeaturesanddiagnosisoftuberculosisoftheappendix.MethodFifteencases(0.27%)withtuberculosisofappendixselectedfrom5621histopathologicalyexaminedappendectomyspecimensbetweenJune1959andMay1995wereanalysedretrospectively.ResultsAlthecaseswithtuberculosisofappendixwerecommonlyoccuredintheyoung(≤34yearsin12cases)andinfemales(in11cases).Theywereusualysecondarytotuberculo-siselsewhereintheabdomen.Bymicroscopy,proliferativetypeofthelesionswerefoundin11cases,whileulcerativetypein4cases.Fourteencases(accountingfor93%)wereclinicalymisdiagnosed.Itwasdificulttobedifferentiatedfromchronicappendicitis,tuberculosisortumoroftheileocecumandmalignanttumoroftheappendix.ConclusionsDefinitediagnosisoftuberculosisoftheappendixmainlydependonthehistopathologicalexamination.Itisrecommendedthatinordertoavoidmisdiag-nosis,althesurgicalyremovedappendixspecimensshouldbehistopathologicalyexamined,nomatterwhetherthespecimensaremacroscopicalynormalornot.