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外科研究与新技术 ›› 2016, Vol. 5 ›› Issue (1): 44-48.

• 论著 • 上一篇    下一篇

?肉芽肿性多血管炎临床病理特点并文献复习

闫利娟1,朱剑2   

  1. 1. 洛阳市第二中医院病理科
    2. 上海兰卫医学检验所病理实验室
  • 收稿日期:2015-11-09 修回日期:2015-11-21 出版日期:2016-03-28 发布日期:2016-03-08
  • 通讯作者: 朱剑 E-mail:zhujian770@aliyun.com

Granulomatosis with polyangiitis: clinical and pathologic features and review of the literature

,   

  • Received:2015-11-09 Revised:2015-11-21 Online:2016-03-28 Published:2016-03-08

摘要: [摘要] 目的 探讨肉芽肿性多血管炎的临床病理特点。方法 回顾性分析1例肉芽肿性多血管炎患者的临床、实验室检验及影像学特征并文献复习。结果 肉芽肿性多血管炎患者胸部CT检查:双肺可见多结节状密度增高影,边界不清,密度不均,周围见毛刺及浅分叶,局部与胸膜相连;鼻窦CT检查左侧副鼻窦炎。实验室检查抗中性粒细胞核周抗体IgG型阳性(+)。 鼻腔手术活检及肺穿刺活检均可见坏死及肉芽肿,肺活检局部可见血管炎改变。结论 肉芽肿性多血管炎是一种累及呼吸道、肺、肾的坏死性肉芽肿性血管炎,发病率低,预后较差;及时明确诊断是治疗关键,在影像学及实验室检查尚不能明确诊断的情况下,可选择活检明确诊断。

关键词: 肉芽肿性多血管炎, 肉芽肿, 血管炎

Abstract: [Abstract] Objective To explore the clicicopathologic features of granulomatosis with polyangiitis(GPA). Methods The clinical, laboratory analysis and radiologic features of one GPA case were analyzed retrospectively and the related literatures were reviewed. Results Computed tomography of the chest showed bilateral pulmonary multinodular high density shape with obscure margin, inhomogeneous density .Spicula and lobulated can be seen in surroundings, with part adhering to the pleural. Sinuses CT scanned left paranasal sinusitis. The laboratory analysis showed a positive test of anti-antineutrophil cytoplasmic antibody .The biopsy sample were got from nasal cavity operation and lung puncture. The pathological morphology presented with necrotizing granulomatous, local changes in vasculitis. Conclusion GPA is a kind of necrotizing granulomatous vasculitis, which involves respiratory, lung and kidney with low incidence and poor prognosis; The clinicians can choose biopsy in the case of laboratory and radiologic failed definitive diagnosis, for the timely diagnosis is the key of treatment.

Key words: Granulomatosis with polyangiitis, Granulomas, Vasculitis