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Lenta胆管炎12例临床病理分析

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目的 探讨Lenta胆管炎的临床病理学特征.方法 收集12例Lenta胆管炎患者的临床资料,采用HE染色、组织化学染色和免疫组化法对12例Lenta胆管炎进行检测,并复习相关文献.结果 12例Lenta胆管炎患者均有急性发病史和肝功能指标异常,9例(75.0%)白细胞计数异常,11例(91.7%)有腹腔感染,8例(66.7%)有全身炎症反应综合征,8例(66.7%)确诊为脓毒症.常见病理学表现包括点状坏死(100%)、碎屑样坏死(100%)、融合性坏死(75.0%)、桥接坏死(66.7%)、肝细胞和毛细胆管淤胆(75.0%)、汇管区轻微水肿(33.3%),12例均有汇管区周围细胆管增生,扩张细胆管内见浓缩胆汁,均无小叶间胆管淤胆.12例均有原发肝病基础.2例(16.7%)患者转院治疗后死亡,10例(83.3%)患者存活,随访时间7~55个月.结论 Lenta胆管炎表现出独特的临床表现和形态学特征,常在基础疾病上伴发;肝活检组织中出现Lenta胆管炎,常提示患者可能有脓毒症和(或)腹腔感染,诊断时应综合患者的临床特征、实验室检查和影像学表现.
Cholangitis Lenta:a clinicopathological analysis of twelve cases
Purpose To explore the clinicopathological features of cholangitis lenta.Methods The clinical data of 12 patients with cholangitis Lenta were collected,HE staining,his-tochemical staining and immunohistochemistry were used to de-tect the clinicopathological changes in 12 cases of cholangitis lenta,and the relevant literature was reviewed.Results All the 12 patients with cholangitis Lenta had acute history and ab-normal liver function,9 cases(75.0%)had abnormal white blood cell count,11 cases(91.7%)had abdominal infection,8 cases(66.7%)had systemic inflammatory response syndrome(SIRS)and 8 cases(66.7%)were diagnosed as sepsis.The common pathological manifestations included spotty necrosis(100%),piecemeal necrosis(100%),confluent necrosis(75.0%),bridging necrosis(66.7%),hepatocyte and capil-lary cholestasis(75.0%),and mild edema in portal area(33.3%).12 cases showed proliferation of bile ductules around the portal area,inspissated bile in dilated bile ductules and no cholestasis in interlobular bile ducts.12 cases had the basis of primary liver disease.2 patients(16.7%)died after being transferred to another hospital for treatment,and 10 patients(83.3%)survived,which lasted for 7 to 55 months.Conclu-sion Cholangitis Lenta shows unique clinical manifestations and morphological features,it is often accompanied by underly-ing diseases.The pathological manifestation of cholangitis Lenta in liver biopsy suggests that patients may have sepsis and/or ab-dominal infection,and therefore its diagnosis should be com-bined with clinical features,laboratory examination and imaging manifestations.

cholangitis Lentasepsisabdominal infection

王雪芳、陈丽红、黄丽云、吴丽霞、林秋香、王斌

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福建医科大学孟超肝胆医院病理科,福州 350025

福建医科大学基础医学院病理学系,福州 350004

福建医科大学孟超肝胆医院肝内科,福州 350025

Lenta胆管炎 脓毒症 腹腔感染

福建省自然科学基金福州市科技计划项目

2020J016052022-S-008

2024

临床与实验病理学杂志
安徽医科大学,中华医学会安徽分会

临床与实验病理学杂志

CSTPCD北大核心
影响因子:0.776
ISSN:1001-7399
年,卷(期):2024.40(6)