假结核耶尔森菌肠系膜淋巴结炎(附1例报告并文献复习)

The Mesenteric Lymphoadenitis Caused by Yersinia Pseudotubercolosis:A Case Report and Review of Literature

目的:探讨假结核耶尔森菌肠系膜淋巴结炎的临床病理特征。方法:应用光镜、特殊染色方法对1例假结核耶尔森菌肠系膜淋巴结炎进行组织学观察并复习文献。结果:肠系膜淋巴结内见多发性坏死灶和微脓肿,在坏死灶、微脓肿的外周有上皮样细胞包绕,形成中心化脓性肉芽肿。阑尾壁全层慢性炎,黏膜下淋巴滤泡增生,滤泡中心可见上皮样肉芽肿。革兰氏染色查见革兰氏阴性杆菌。结论:耶尔森菌肠系膜淋巴结炎好发于儿童和青少年,假结核耶尔森菌肠系膜淋巴结炎十分罕见,临床表现类似急性阑尾炎,极易误诊,诊断有赖于光镜和特染。

Objective： To investigate the clinicopathologic characteristics of the mesenteric lymphoadenitis caused by yersinia pseudotubercolosis. Methods： A case of the mesenteric lymphoadenitis caused by Y. pseudotubercolosis was studied by histopathology observation and specific staining, with review of the literature. Results： The multiple dots of necrosis and micmabscess which circled by epithelioid cells were noted in the mesenteric lymph nodes, with formation of central pyogenic granuloma. There were chronic inflammation throw the wall of the appendix, with hyperplasia in the submucosal lymphoid follicles. The epithelioid granuloma could be found in central follicles. Gram - negative bacterium could be found. Conclusions： The mesenteric lymphoadenitis caused by yersinia often occurs in children and youth. The mesenteric lymphoadenitis caused by yersinia pseudotubercolosis was rarely reported. The clinical symptom was similar to acute appendicitis, easily to misdiagnosised. The diagnosis was based on histopathologic and specific staining.