18例胃肠道巨细胞病毒感染的临床病理分析  

Gastrointestinal cytomegalovirus infection:a clinical and pathological analysis of 18 cases

作　　者：马进[1] 普文静[1] 王玉环[1] MA Jin;PU Wen-jing;WANG Yu-huan(Department of Pathology,People’s Hosiptal of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院病理科,乌鲁木齐830001

出　　处：《诊断病理学杂志》2023年第7期652-656,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胃肠道巨细胞病毒(CMV)感染的临床表现,内镜下特点及病理形态特点。方法回顾性分析18例胃肠道CMV感染患者的临床及辅助检查资料,结合组织学形态、免疫组化结果,分析其临床病理特点。结果患者的临床症状多为腹痛等非特异性表现,内镜下多为溃疡表现;镜下主要表现为黏膜糜烂、坏死、炎症及溃疡形成,在渗出坏死物、炎性肉芽组织和溃疡底部纤维组织等区域,尤其是肉芽组织内增生的血管内皮细胞间,最易观察到数目不等的“巨细胞”,即CMV感染的特征性细胞。其体积明显增大,嗜碱性细胞核内见病毒包涵体结构,部分包涵体小,周围有空晕,可形成“鹰眼”样征象,部分可见嗜酸性颗粒状胞质,但周边黏膜组织内则罕见有感染细胞分布。免疫组化能够很好地辅助诊断CMV感染细胞。结论对于CMV的诊断需要临床与病理结合,从而减少、避免误漏诊。Objective To investigate the clinical,endoscopic and pathological features of cytomegalovirus(CMV)gastrointestinal tract infection.Methods The clinical and auxiliary examination data of 18 cases with CMV infection in gastrointestinal tract were analyzed retrospectively.Results Most of the patients’clinical symptoms were non-specific manifestations such as abdominal pain,and most of them were ulceration under endoscope;and most of them were mucosal erosion,necrosis,inflammation and ulceration under endoscopy,in areas such as exudative necrosis,inflammatory granulation tissue,and fibrous tissue at the bottom of the ulcer,particularly in the endothelial hyperplasia within the granulation tissue,varying numbers of“giant cells”were most readily observed,which were the characteristic cells of CMV infection.The virus inclusion bodies were found in basophilic nucleus,some of them were small,and there were empty halo around them,which could form eagle's eye-like sign,and some of them could be seen eosinophilic granular cytoplasm;however,the distribution of infected cells in peripheral mucosa was rare.Immunohistochemistry could be used to diagnose CMV infection.Conclusion The diagnosis of CMV needs the combination of clinical analysis and pathological evaluation so as to reduce and avoid misdiagnosis and missed diagnosis.

关 键 词：巨细胞病毒 胃肠道 临床特点 病理形态 免疫组化 

分 类 号：R57[医药卫生—消化系统]