Laumonier R, Tayot J, Halkin E
Sem Hop. 1979;55(37-38):1689-99.
The authors summarize the difficulties in diagnosis some tumour-like lesions or digestive tumours. They rely upon thirty years experience in digestive pathology and upon a survey of relevant literature. They recall the difficulties arising from the inflammatory tumour-like lesions (infiltrating sclerosis or granulomas, colitis cystica profunda, inflammatory polyps). They mention the circumstances which bring about errors or incomplete diagnosis among these very tumours. Some difficulties are due to the circumstances in which these tumours appear : the digestive cancers of the child, the assocations of some family cancers (the ill-forming tumours and the dysembryoplasic cancers, and lastly the connections that exist between some inflammatory or dystrophic diseases and tumours. Other difficulties depend upon the topography or the tumorous structure. Paneth-cell carcinomas, goblet cell carcinoid are chosen as instances among epithelial tumours. In the group of non-epithelial tumours, digestive localizations of angiomatosis and of lymphomatosis may cause errors. Likewise this can be applied to some secondary digestive tumours. Regarding these difficulties, the authors stress the necessity of a close cooperation between gastro-enterologists, surgeons and pathologists. They also stress the strict observance of techniques in fixation and preparation of specimens and biopsies, and also the necessity of completing, if need be, the habitual microscopy through more elaborate explorations (histochemistry, electron microscopy...).
作者总结了诊断一些肿瘤样病变或消化道肿瘤的困难。他们依据在消化病理学方面三十年的经验以及对相关文献的调研。他们回顾了炎症性肿瘤样病变(浸润性硬化或肉芽肿、深部囊性结肠炎、炎性息肉)所引发的困难。他们提及了在这些肿瘤中导致误诊或诊断不完整的情况。一些困难归因于这些肿瘤出现的情形:儿童消化道癌症、某些家族性癌症的关联(发育不良性肿瘤和胚胎发育异常性癌症),以及最后一些炎症性或营养不良性疾病与肿瘤之间存在的联系。其他困难则取决于肿瘤的部位或结构。在上皮性肿瘤中,选择潘氏细胞癌、杯状细胞类癌作为例子。在非上皮性肿瘤组中,血管瘤病和淋巴瘤病的消化道定位可能会导致误诊。同样,这也适用于一些继发性消化道肿瘤。关于这些困难,作者强调胃肠病学家、外科医生和病理学家之间密切合作的必要性。他们还强调在标本和活检的固定及制备过程中严格遵守技术规范,以及在必要时通过更精细的检查(组织化学、电子显微镜检查等)来完善常规显微镜检查的必要性。