Kourda N, Blel A, Ben Jilani S Baltagi, Zermani R
Service d'anatomie et de cytologie pathologiques. Hôpital Charles-Nicolle, boulevard du 9-Avril-1938, 1006 Tunis, Tunisie.
Bull Soc Pathol Exot. 2008 Feb;101(1):22-3.
Cryptosporidium, agent of cryptosporidiosis, is an ubiquitous protozoan organism causing diarrhoea especially in severe immunosuppressed patients. Cryptosporidium has been detected with increasing frequency in the gastrointestinal tract, but involvement of the stomach is rarely reported and discloses an underlying immunodeficiency state. We report the case of 67-year-old man, a heavy smoker, who presented with a history of epigastric pain with an altered general condition. Upper gastrointestinal endoscopy showed no significant mucosal abnormalities. The biopsy revealed a chronic active gastritis with Cryptosporidium parasites lining cryptic epithelium. Systematic chest X ray showed a right suspect parenchymatous opacity. Bronchoscopy with multiple biopsies concluded to a small cell lung carcinoma. Through this rare initial manifestation of immunocompromised state related to cancer we will discuss the role of gastrointestinal endoscopy with biopsies in the diagnosis of cryptosporidiosis.
隐孢子虫是隐孢子虫病的病原体,是一种普遍存在的原生动物,可引起腹泻,尤其是在严重免疫抑制的患者中。隐孢子虫在胃肠道中的检出频率越来越高,但胃受累的情况很少报道,且提示存在潜在的免疫缺陷状态。我们报告了一例67岁男性病例,该患者有重度吸烟史,出现上腹部疼痛并伴有全身状况改变。上消化道内镜检查未发现明显的黏膜异常。活检显示为慢性活动性胃炎,隐窝上皮内有隐孢子虫寄生虫。胸部X线检查显示右肺有可疑实质性阴影。支气管镜检查及多次活检诊断为小细胞肺癌。通过这种与癌症相关的免疫功能低下状态的罕见初始表现,我们将讨论胃肠内镜活检在隐孢子虫病诊断中的作用。