自身免疫性胰腺炎组织病理学特征分析  

Analysis on histopathological features of autoimmune pancreatitis

作　　者：张新刚[1] 张新鹏[2] 李晓晗[3] 张晓莉[1] 蒋莉[1] 郭韵[1] 王晓非[1] 

机构地区：[1]中国医科大学附属盛京医院风湿免疫科,辽宁沈阳110022 [2]沈阳市第四人民医院脑外科,辽宁沈阳110031 [3]中国医科大学附属盛京医院病理科,辽宁沈阳110022

出　　处：《中国实用内科杂志》2015年第12期1027-1030,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81272970);2014年辽宁省科学技术计划(博士启动基金)(20141043);2012年沈阳市科学计划项目(F12-193-9-41)

摘　　要：目的分析自身免疫性胰腺炎(autoimmune pancreatitis,AIP)患者的组织病理学资料,以提高对AIP的早期识别。方法选取2003年1月至2011年10月中国医科大学附属盛京医院外科收治的术后病理符合AIP亚洲标准的患者36例,总结AIP患者的组织病理学特点。结果 AIP组织病理学具有以下特点:(1)间质席纹状纤维化、大量淋巴细胞浆细胞浸润及闭塞性静脉炎为最具特征性的改变;(2)Ig G4+CD38+CD138+浆细胞大量浸润且每高倍视野大于30个具有高度特异性;(3)可伴嗜酸粒细胞、中性粒细胞等浸润;(4)组织坏死及肉芽肿样改变未见,腺泡萎缩、导管排列紊乱及上皮细胞非典型增生、纤维母细胞增生、淋巴滤泡形成、黏液变性及胶原化等改变不特异;(5)胰石可能是AIP复发的结果和标志。结论 AIP具有特征性的组织病理学特点,可作为与胰腺癌等胰腺疾病的鉴别诊断依据之一。Objectives To improve the early identification of autoimmune pancreatitis（AIP） by a N analysis of histopathological features from AIP patients. Methods The analysis included 36 patients admitted by the surgery department of our hospital from January 2003 to October 2011 who had postoperative pathological findings consistent with Asian AIP standards. The pathological characteristics of these AIP patients were analyzed. Results Histopathology revealed the following characteristics：（1）interstitial storiform fibrosis, the infiltration of large amount of lymphocytes and plasma cells, and obliterative phlebitis were the most characteristic changes;（2）infiltration of a large number of Ig G4＋CD38＋CD138＋ plasma cells infiltration with more than 30 cells per high-power field was specific;（3）it was accompanied by the infiltration of eosinophil cell and neutrophil;（4）tissue necrosis and granuloma-like change were not discovered, with atrophy of acinar cells, and disordered arrangement ductal epithelial cells, and atypical hyperplasia, fibroblast hyperplasia, lymphoid follicular formation, mucoid degeneration and collagen were not specific;and（5）the pancreatic stone might be the result and sign of the recurrence. Conclusion AIP has distinctive pathological characteristics, which could be used for its differentiation from pancreatic cancer.

关 键 词：自身免疫性胰腺炎 病理学 

分 类 号：R593.2[医药卫生—内科学]