肝脏孤立性坏死性结节临床病理分析及组化研究

THE CLINICOPATHOLOGY ANALSIS AND HISTOCHEMISTRY STUDY OF SOLITARY NECROTIC NODULE IN LIVER

目的对4例较为罕见的肝脏孤立性坏死性结节的病因、病理形态学特点及组织化学染色结果等做一初步探讨。方法标本采用常规石蜡切片,HE,PAS,六胺银及抗酸杆菌染色,光镜观察。另对石蜡切片采用EnV ision免疫组化二法染色。结果4例患者中有男性及女性各2例,发病年龄26-52岁,平均发病年龄41.5岁。显微镜下见4例病变内均为大片的坏死组织,在坏死组织的周边可见明显的纤维组织增生,在增生的纤维组织内及其周围可见弥漫多量淋巴细胞及浆细胞浸润。在4例坏死组织周围均可见多少不一的嗜酸性白细胞浸润,其中3例尚可见少数多核巨细胞反应。结论本组4例患者在病变内均未见病原体,在坏死组织周围可见多少不一的嗜酸性白细胞浸润,其形态学改变支持病变可能与寄生虫感染有关。

Objective To explore the etiology, clinicopathologic and histiochemical stain features of four cases of solitary necrotic nodule in livers. Methods The samples were studied by using of paraffin slices, HE, Gomori-Burtner and Ziehl-Neelsen staining, immunochemistry method（ En Vision method）and observed under microscopy. Results Of the four cases, two were male,and the other two were female. The ages ranged from 26 to 52 years, and the mean age was 41.5 year. Under microscope, large pieces of necroses could be seen in the center of the lesions. Around the necrosesm, there was obviously proliferative fibro tissue, and great many lympho- cytes,plasmacytes, and vary amount of eosinophile could be seen infiltrating in it. In 3 cases, a few or some multiple nuclear giant cells could be seen. Conclusion In the four cases, no etiologic agents could be found, andaround the necroses, vary amount of eosinophile could be seen, which sustained the theory that the lesions might relate to the infection of parasites.