Vuong P N, Le Bourgeois P, Houissa-Vuong S, Martin P, Berrod J L
Unité d'Anatomie et de Cytologie Pathologiques, Hôpital Saint-Michel, 33 rue Olivier de Serres, Paris 75015 Paris, France.
J Mal Vasc. 2001 Feb;26(1):65-8.
A 78 year-old woman, suffering from a von Recklinghausen's disease sought medical assistance for hematemesis with anemia. This patient had previously experienced an amputation of the right arm for gangrene. Gastric fibroscopy unveiled a deep chronic ulcus developed in the antrum, highly suspect of malignancy. Multiple biopsies of the ulcer showed mainly interstitial gastritis. The persistence of the hematemesis imposed a subtotal gastrectomy. Pathological examination of the operative specimen evidenced an ischemic ulcer caused by arterial intimal muscular fibrodysplasia with associated neurofibromatosis in the neighboring sub-mucosal layer. This case report highlights the frequent association of phacomatosis especially von Recklinghausen's disease, with vascular lesions whose clinical expression mainly depends on the involved vascular area.
一名78岁患有冯·雷克林霍增氏病的女性因呕血伴贫血寻求医疗救助。该患者此前因坏疽接受了右臂截肢手术。胃镜检查发现胃窦部有一个深度慢性溃疡,高度怀疑为恶性。对溃疡进行的多次活检主要显示为间质性胃炎。由于呕血持续存在,遂进行了胃次全切除术。手术标本的病理检查证实是由动脉内膜肌纤维发育异常引起的缺血性溃疡,相邻黏膜下层伴有神经纤维瘤病。本病例报告强调了错构瘤病尤其是冯·雷克林霍增氏病与血管病变的频繁关联,其临床表现主要取决于受累的血管区域。