Kubota K, Reinholt F P, Tydén G, Bohman S O, Groth C G
Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden.
Surgery. 1991 Apr;109(4):507-14.
In 19 patients who had undergone pancreatic transplantation with temporary exteriorization of the pancreatic juice, graft tissue became available for histologic examination. In these patients the cytologic patterns in the pancreatic juice were compared with the histologic findings in the graft specimens. In five samples the diagnosis by cytologic studies was rejection. Acute rejection was confirmed in all the histologic specimens. In eight cytologic samples, graft pancreatitis was suspected because of the increased amounts of neutrophils, degenerating cells, epithelial cells, monocytes, and some macrophages, with or without necrotic tissue fragments. All eight histologic specimens showed findings characteristic of pancreatitis. In three cytologic samples, bacteria or fungi were observed. Histologic examination of these patients showed graft pancreatitis. In four patients the cytologic findings were normal. Graft histologic factors were normal in two instances. In one of these grafts there was graft pancreatitis, and in one graft chronic vascular rejection was seen. Our study shows that two different pathologic events occurring in the pancreatic graft (i.e., acute rejection and pancreatitis) are reflected by characteristic changes in pancreatic juice cytology.
在19例接受胰腺移植且胰液暂时外置的患者中，获取了移植组织用于组织学检查。对这些患者胰液中的细胞学模式与移植标本的组织学发现进行了比较。在5份样本中，细胞学研究诊断为排斥反应。所有组织学标本均证实为急性排斥反应。在8份细胞学样本中，由于中性粒细胞、变性细胞、上皮细胞、单核细胞及一些巨噬细胞数量增加，伴有或不伴有坏死组织碎片，怀疑存在移植胰腺炎。所有8份组织学标本均显示出胰腺炎的特征性表现。在3份细胞学样本中观察到细菌或真菌。对这些患者的组织学检查显示为移植胰腺炎。4例患者的细胞学检查结果正常。其中2例移植组织学因素正常。在其中1例移植中存在移植胰腺炎，另1例移植中可见慢性血管排斥反应。我们的研究表明，胰腺移植中发生的两种不同病理事件（即急性排斥反应和胰腺炎）可通过胰液细胞学的特征性变化反映出来。
