慢性胃溃疡并发霉菌感染16例临床病理分析

Pathologic examination of chronic gastric ulcer with concurrent mycotic infection in 16 cases

目的:探讨慢性胃溃疡并发霉菌感染的发病机理、临床表现和病理形态特点。方法:对慢性胃溃疡并发霉菌感染16例进行回顾性临床病理分析。石蜡切片,常规HE染色和PAS、Grams等特殊染色,光镜观察。结果:慢性胃溃疡并发霉菌感染时,霉菌在溃疡面生长,引起嗜酸性肉芽肿,并在肉芽组织和瘢痕组织内形成钻凿样窦道,溃疡增大、加深等病理形态改变,使病人的临床表现出现变化。结论:慢性胃溃疡是并发霉菌感染的病理基础,诊断主要根据病理检查,在病灶内找见霉菌菌丝。

Objective ： To study the pathogenic mechanism of chronic gastric ulcers with concurrent mycotic infection and its clinical manifestation and pathogenic findings. Methods： 16 cases of chronic gastric ulcer patients with concurrent mycotic infection were scanned and examined pathologically by employing paraffin method, HE staining , PAS staining , Gram＇ staining as well as microscopic observations. Results： When there was an occurrence of chronic gastric ulcer with concurrent mycotic infection, the growing mould fungus on ulcerated surface resulted in formation of acidophilic granuloma accompanied by forming sinusoid pattern - like interstitial space into granulation tissues and cicatricial tissues, enlarged surrounding ulcer tissues and pathological variation, which caused clinical manifestation varied in patients. Conclusion： The occurrence of concurrent mycotic infection preludes chronic gastric ulcer, but a convinced diagnosis relies on detecting mycelium in gastroscopic observation and living specimen from gastrectomy via pathological findings.