儿科克朗氏病:在最初呈现时的组织学发现
Smiljana Spasic1, Amaya Pankaj2, Jess L Kaplan3
1Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA.
Journal of clinical pathology
|July 18, 2024
概括
儿科克罗恩病 (CD) 的组织学诊断可能具有挑战性. 胃肠道活检中的微粒瘤是CD特异性的,经常被忽视,而食道淋巴细胞瘤可能预测需要积极治疗.
科学领域:
- 胃肠病学 胃肠病学
- 儿科病理学 儿科病理学
- 炎症性肠道疾病是什么
背景情况:
- 儿科克罗恩病 (CD) 的组织学诊断存在重大挑战.
- 评估未经治疗的儿科CD活检的组织谱对于诊断准确性至关重要.
研究的目的:
- 评估儿科CD中组织学发现的诊断和预测价值.
- 为了识别儿科CD中未被认可的组织学特征.
主要方法:
- 来自三个队伍的胃肠道 (GI) 活检的回顾性分析:儿科CD (n=137),性结肠炎 (UC) (n=116) 和对照组 (n=50).
- 评估活跃和慢性炎症,包括淋巴细胞模式食道炎,胃炎,末端结肠炎,结肠炎,颗粒瘤和微粒瘤.
主要成果:
- 在48.9%的CD患者中观察到微粒瘤,通常以前错过,并且与UC和对照相比,特定于CD.
- 淋巴细胞模式食道炎 (15%) 和扩散性胃炎 (50.4%) 在儿童CD中很常见.
- oesophageal 淋巴细胞瘤与增加的抗瘤坏死因子 (TNF) 治疗需求相关 (p=0.007).
结论:
- 胃肠道微粒瘤是CD特异性的,在儿科病例中经常被忽视.
- oesophageal 淋巴细胞症可能表明需要在儿科CD中采取更积极的治疗.
- 这项研究强调了儿童CD的未被认可的组织学方面,包括微粒瘤流行率和胃炎模式.
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