Drut R, Altamirano E
Department of Pathology, Superiora Sor María Ludovica Children's Hospital, La Plata, Argentina.
J Clin Pathol. 2008 Mar;61(3):382-4. doi: 10.1136/jcp.2007.049841. Epub 2007 Aug 10.
To report three children displaying gastric metaplasia antral pyloric type of the small bowel mucosa.
Analysis of clinical, histopathological and immunohistochemical data.
The first patient was a 14-year-old girl with history of chronic intestinal pseudo-obstruction and chronic jejunitis; the second patient was a 6-year-old girl with a long-lasting jejunostomy; and the third patient was a 5-year-old girl with ileal-rectal anastomosis. The foci of gastric metaplasia were obvious with H&E-stained sections. The cells at the gastric metaplasia mucosa proved to be MUC-1 and sialyl-Tn positive by immunohistochemistry and they were in a pattern that was different from that of the adjacent mucosa; the cells were autofluorescent in H&E-stained sections.
Gastric metaplasia of the small bowel mucosa in these cases seems to have resulted from chronic inflammation and persistent regenerative activity. This has rarely been reported outside Crohn disease, and if ever in children.
报告3例小肠黏膜出现胃化生(胃窦幽门型)的儿童病例。
对临床、组织病理学及免疫组化数据进行分析。
首例患者为一名14岁女孩,有慢性肠道假性梗阻和慢性空肠炎病史;第二例患者为一名6岁女孩,有长期空肠造口术史;第三例患者为一名5岁女孩,有回肠-直肠吻合术史。苏木精-伊红(H&E)染色切片显示胃化生灶明显。免疫组化结果显示,胃化生黏膜处的细胞MUC-1和唾液酸化-Tn呈阳性,且其模式与相邻黏膜不同;这些细胞在H&E染色切片中呈自发荧光。
这些病例中小肠黏膜的胃化生似乎是由慢性炎症和持续的再生活动引起的。除克罗恩病外,这在其他疾病中鲜有报道,在儿童中更是罕见。