白血病胃肠道损害的临床及病理  

THE CLINICOPATHOLOGIC CHANGES OF LEUKEMIC GASTROINTESTINAL TRACT LESIONS

作　　者：张素芬[1] 王海林[1] 郭步云[1] 黄文臣[2] 唐谊海[2] 孙文利[2] 

机构地区：[1]沈阳军区总医院血液科,110015 [2]沈阳军区总医院病理科,110015

出　　处：《解放军医学杂志》1993年第5期323-325,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：作者就沈阳军区总医院1953～1990年收治的白血病中104例剖检病例,对其胃肠道的临床表现及病理损害进行探讨。104例中仅11例病程中有胃肠道症状,如腹痛、腹泻、便血,48例查便,仅6例有便的异常。其病理特点有出血、糜烂、溃疡、白血病细胞浸润及淤滞,其出血为点状或片状出血,出血区多半平坦、不规则,部分出血区隆起,部分有粘膜上皮脱落,表面有渗出,少数有坏死形成糜烂或溃疡,特点为多发性。病理特征和一般消化性溃疡病不同,白血病细胞浸润率以固有层高,而浸润程度以粘膜下层及血管周围为重。一般病例白血病细胞胃肠道浸润本身往往缺乏临床症状,胃肠道出现的症状主要是因糜烂、溃疡、继发感染、出血等继发性病变所引起。This paper investigates the clnicopathologic changes in the gastrointestinal tract in 104 autopsied leukemic patients collected from 1953 to 1990 years. Only 11 of 104 cases showed the symptoms of gastrointestinal tract disorders, such as abdominal pain, diarrhea and hematochezia during the cause of disease. In 48 cases, only 6 showed abnormal findings in fecal examination. The characteristics of pathological changes were bleeding, erosion, ulcer, leukemic cell infiltration and stasis. The bleeding was mainly petechial or patchy, flat and irregular, with only a few raised. In some cases, there was exfoliation of mucosal epithelium, with exudation on its surface. In a few cases, necrosis occurred leading to formation of multiple erosions or ulcers. The infiltration of leukemic cell is mostly seen in lamina propria, and infiltration was the heaviest in the submucosal layer and perivascular space. Generally the leukemic cell infiltration of gastrointestinal tract itself often lacked clinical symptoms. The symptoms of gastrointestinal tract were mainly caused by erosion, ulcer, secondary infections, bleeding, and so on.

关 键 词：白血病 胃肠道损害 病理 

分 类 号：R733.702[医药卫生—肿瘤]