Budd-Chiari综合征:下腔静脉阻塞区钳夹活检病理学探讨

Budd-Chiari syndrome:the study of pathological features of inferior vena cava obstuction by biopsy

目的分析Budd-Chiari综合征(BCS)下腔静脉(IVC)阻塞区的病理学改变,探讨其可能的病因和发病机制。方法对13例BCS患者IVC阻塞区进行钳夹活检,对取得标本行病理学检查。结果钳夹活检技术成功率100%(13/13),病理阳性率92.3%(12/13)。镜下见单纯混合血栓1例;纤维结缔组织11例,其中伴血栓形成3例,伴炎性细胞浸润8例,纤维结缔组织玻璃或黏液变性。结论BCS的IVC阻塞可能为局部炎症引起血栓形成并逐渐机化和纤维化而成。

Objective To investigate the pathogenesis of inferior vena cava obstruction for Budd-Chiari syndrome（BCS） patients. Methods Forceps biopsy was carried out at the obstructed site of inferior vena cava （IVC） in 13 patients with BCS. The specimens were then studied under light microscopy. Results The technical successful rate of forceps biopsy reached 100% （ 13/13 ）, with sensitivity of 92.3% （ 12/13 ）. One of them showed simple mixed thrombus; 11 demonstrated proliferation of fibrous connective tissue, with hyalinization or mucoid degeneration under light microscopy, including thrombi formation in 3 and inflammatory cells infiltration in 8. Conclusion IVC obstruction in BCS probably may due to gradual fibrous organization of thrombi induced by local inflammatory change. （J Intervent Radiol, 2006, 15： 530-532）