手部非结核分枝杆菌病临床病理特征  

Clinicopathological features of nontuberculosis mycobacterial disease of the hands

作　　者：郭瑞珍[1] 王章奇[2] 吴晓媚[2] 

机构地区：[1]遵义医学院珠海校区病理学教研室,珠海519041 [2]遵义医学院第五附属医院病理科,珠海519100

出　　处：《诊断病理学杂志》2013年第11期711-713,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的介绍手部非结核分枝杆菌病的临床病理特征。方法对25例手部非结核分枝杆菌病的病例进行回顾性分析，结合临床表现、组织学特点进行诊断和鉴别诊断。结果本组25例中男性14例，女性11例；临床Ⅱ型10例，Ⅲ型15例；病变累及拇指2例，食指11例，中指10例，环指1例，小指1例；皆有被鱼、虾刺伤史。组织学特点是有慢性炎细胞浸润、肉芽肿性病灶、非干酪样坏死和化脓性坏死病变。临床曾漏诊、误诊4例。结论手部非结核分枝杆菌病多见于30—60岁成年人，患者均有鱼虾接触史或被刺伤史，84％的病灶位于食指和中指；组织学特点是非干酪样坏死性、化脓性和肉芽肿性病变，正确的诊断对指导临床治疗有重要价值。Objective To introduce the clinicopathological features of nontuberculosis mycobacterial disease. Methods Total 25 cases of nontuberculosis mycobacterial disease of the hands were retrospectively analyzed, combined with clinical manifestations, diagnosis and differential diagnosis of histological features. Results The patients included 14 males and 11 females;Clinically, there were typeⅡ （10 cases） and type Ⅲ （15 cases） ;The lesion was involved in thumb 2 cases, index finger （ 11 cases）, middle finger （ 10 cases）, ring finger （ 1 case） and little finger （ 1 case）. The clinical history of thorn damage by fish and shrimp was described. The histological features included chronic inflammatory cell infiltration, granulomatous lesions,non-caseous necrosis and purulent necrosis lesions. Four cases were misdiagnosed. Conclusions The nontuberculosis mycobacterial disease is more commonly found in adults of 50 to 60 years old, 100% of patients have a history of fish and shrimp contact or stabbed, and 84. 0% of the lesions are located in the index finger and middle finger.The histological features are granulomatous lesions, non-caseous necrosis and purulent necrosis lesions. The correct diagnosis has very important values in guiding clinical treatment.

关 键 词：手部 非结核分枝杆菌 非结核分枝杆菌病 病理诊断 鉴别诊断 

分 类 号：R517.9[医药卫生—内科学]