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由于免疫球蛋白G4相关疾病引起的结肠阻塞的 laparoscopic切除:一个案例报告

Hitoshi Kameyama¹, Gen Tomizawa¹, Toshiyuki Yamazaki¹

¹Department of Digestive Surgery, Niigata City General Hospital, Niigata, JPN.

|March 3, 2025

概括

一种罕见的IgG4相关疾病,模仿结肠癌的病例,呈现为减肥和贫血. 手术切除和活检证实了IgG4相关的疾病,而不是恶性瘤.

科学领域:

胃肠病学胃肠病学
免疫学免疫学免疫学
病理学病理学病理学

背景情况:

与IgG4相关的疾病 (IgG4-RD) 是一种多系统纤维炎症疾病.
IgG4-RD可以模仿各种恶性瘤,包括结肠直肠癌.
准确的诊断对于适当的治疗和患者的结果至关重要.

研究的目的:

报告IgG4相关疾病的病例,呈现为结肠狭窄症.
突出结肠IgG4-RD的诊断挑战和特征.
强调在无法解释的胃肠狭窄症中考虑IgG4-RD的重要性.

主要方法:

一个89岁的妇女的案例研究,体重减轻和贫血.
诊断工作包括下肠道成像,内镜,活检,CT扫描和免疫组织化学.
由于怀疑恶性瘤,进行了手术干预 (镜辅助左半球切除术).

主要成果:

影像检查显示结肠狭窄;活检结果对恶性瘤呈阴性.
免疫组织化学显示IgG4阳性血细胞的增加 (>100/HPF) 和IgG4/IgG比率>40%.
手术后血清IgG4水平处于正常范围内,但根据临床标准确立了可能IgG4-RD的诊断.

结论:

结肠狭窄可能是IgG4相关疾病的表现.
免疫组织化学对于诊断IgG4-RD至关重要,即使血清IgG4水平正常.
早期识别和诊断IgG4-RD至关重要,以防止不必要的手术和指导治疗.

关键词:

结肠癌是什么意思结肠癌是什么意思大肠阻塞结肠阻塞纤维化纤维化与igg4相关的疾病腹腔镜外科手术腹腔镜外科手术

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