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[脾破裂。临床病理相关性及诊断方法]

[Rupture of the spleen. Clinicopathological correlations and diagnostic procedures].

作者信息

Tzankov A, Adams H, Sterlacci W

机构信息

Institut für Pathologie, Universitätsspital, 4031, Basel, Schweiz.

出版信息

Pathologe. 2008 Mar;29(2):148-57. doi: 10.1007/s00292-007-0948-0.

Abstract

Though rare, splenic rupture is the most common indication for splenectomy. In the vast majority of cases ruptures are clearly related to trauma (traumatic ruptures); in other cases there is a pre-existing disease affecting the spleen (pathologic ruptures); and in a minority of patients no obvious reason can be identified (spontaneous ruptures). In approximately 10% of cases an iatrogenic cause, in the broadest sense (including side effects of drugs), and relevant histological findings (approximately half of which will be unexpected) can be anticipated. Knowledge of pathophysiological aspects of splenic rupture and assessment of simple macroscopic findings such as splenic dimensions and weight, and information on macroscopically visible lesions are of key diagnostic importance, as is accurate microscopic examination with targeted histological pattern analysis, supplemented as appropriate by histo- and immunohistochemical studies on adequately prepared material.

摘要

虽然脾破裂很少见,但却是脾切除术最常见的指征。在绝大多数病例中,破裂显然与创伤有关(外伤性破裂);在其他病例中,存在影响脾脏的既往疾病(病理性破裂);而在少数患者中,无法确定明显原因(自发性破裂)。在大约10%的病例中,可以预见最广义的医源性原因(包括药物副作用)以及相关的组织学发现(其中约一半是意外发现)。了解脾破裂的病理生理方面,评估脾脏大小和重量等简单宏观表现,以及宏观可见病变的信息,对于诊断至关重要,准确的显微镜检查及靶向组织学模式分析同样重要,并酌情辅以对充分制备材料的组织学和免疫组织化学研究。

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