Dhillon A P, Anthony A, Sim R, Wakefield A J, Sankey E A, Hudson M, Allison M C, Pounder R E
Department of Histopathology, Royal Free Hospital School of Medicine, London, UK.
Histopathology. 1992 Aug;21(2):127-33. doi: 10.1111/j.1365-2559.1992.tb00360.x.
We studied the initial rectal biopsy from 46 patients in whom subsequent follow-up established the diagnosis of either self-limited colitis or inflammatory bowel disease. An additional 12 non-inflamed rectal biopsies were also studied. There was between 2 and 8 years of follow-up in each of these cases. Staining for fibrin (MSB, fibrinogen), platelets (factor XIIIA, Y2/51), and capillary basement membrane (reticulin, collagen 4) was performed to identify thrombotic material within capillaries. Mucosal capillary thrombi were best identified by staining for factor XIIIA; thrombi were observed in 8/13 cases of ulcerative colitis, 4/10 cases of Crohn's disease, 1/3 cases of unspecified inflammatory bowel disease and 5/20 cases of self-limited colitis. The presence of capillary thrombi was not related to the severity of inflammation, but none of the control biopsies showed capillary thrombi. Their presence seems of little diagnostic value in distinguishing inflammatory bowel disease from self-limited colitis. The pathogenetic significance of these mucosal capillary thrombi is uncertain.
我们研究了46例患者的初始直肠活检样本，这些患者随后的随访确诊为自限性结肠炎或炎症性肠病。另外还研究了12例无炎症的直肠活检样本。这些病例的随访时间为2至8年。对纤维蛋白（MSB、纤维蛋白原）、血小板（因子XIIIA、Y2/51）和毛细血管基底膜（网状纤维、胶原蛋白4）进行染色，以识别毛细血管内的血栓物质。通过对因子XIIIA染色能最好地识别黏膜毛细血管血栓；在13例溃疡性结肠炎病例中有8例观察到血栓，10例克罗恩病病例中有4例，3例未特定的炎症性肠病病例中有1例，20例自限性结肠炎病例中有5例。毛细血管血栓的存在与炎症严重程度无关，但对照活检样本均未显示毛细血管血栓。它们的存在在区分炎症性肠病和自限性结肠炎方面似乎没有什么诊断价值。这些黏膜毛细血管血栓的发病机制意义尚不确定。
