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嗜酸性胆囊炎的临床病理研究:单机构五年经验

Clinicopathological Study of Eosinophilic Cholecystitis: Five Year Single Institution Experience.

作者信息

Khan Sabina, Hassan Mohammad Jaseem, Jairajpuri Zeeba Shamim, Jetley Sujata, Husain Musharraf

机构信息

Associate Professor, Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.

Professor and Head, Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.

出版信息

J Clin Diagn Res. 2017 Aug;11(8):EC20-EC23. doi: 10.7860/JCDR/2017/27886.10427. Epub 2017 Aug 1.

Abstract

INTRODUCTION

Gallbladder diseases are very common in Northern India, most common of which is Chronic Cholecystitis. Rarely, histopathological diagnosis of Eosinophilic Cholecystitis (EC) is given when transmural cellular infiltrate consists of more than 90% eosinophils.

AIM

To determine the prevalence and clinicopathological profile of eosinophilic cholecystitis at a tertiary care hospital of New Delhi.

MATERIALS AND METHODS

This was a retrospective clinicopathological study done on twenty two cases of eosinophilic cholecystitis over a period of five years from January 2011- December 2015. In cases diagnosed histopathologically as eosinophilic cholecystitis, clinical details were obtained from hospital records and slides were retrieved. Various histologic features, pattern of the inflammatory infiltrate and association of EC with other medical diseases, drugs and allergic states were evaluated.

RESULTS

Out of a total of 1370 cholecystectomy specimens received during five year period, Eosinophilic cholecystitis was diagnosed in 22 (1.6%) of the specimens. Clinically, seven of these patients had a clinical diagnosis of acute cholecystitis. Patient's age ranged from 25-64 years and male to female ratio was 1:2.7. Most common symptom reported was abdominal pain. Most of the cases showed gallstones radiologically (90%) while only two cases showed peripheral eosinophilia (9%). Histologically, mucosal and muscular eosinophilic infiltrate was seen in 72.6% of the cases. No association with drug therapy, allergies or other pre-existing medical conditions was noted.

CONCLUSION

EC is a relatively uncommon entity in which histopathology remains the main stay of diagnosis. Although the presentation may be similar to general cholecystitis, if a postoperative histopathological diagnosis of EC is made, then the patient must be investigated thoroughly to rule out other associated disease conditions, which may have a worse prognosis than cholecystitis itself.

摘要

引言

胆囊疾病在印度北部非常常见,其中最常见的是慢性胆囊炎。很少情况下,当透壁性细胞浸润中嗜酸性粒细胞超过90%时,会做出嗜酸性胆囊炎(EC)的组织病理学诊断。

目的

确定新德里一家三级护理医院中嗜酸性胆囊炎的患病率和临床病理特征。

材料与方法

这是一项回顾性临床病理研究,对2011年1月至2015年12月五年间的22例嗜酸性胆囊炎病例进行研究。对于组织病理学诊断为嗜酸性胆囊炎的病例,从医院记录中获取临床细节并检索切片。评估各种组织学特征、炎症浸润模式以及EC与其他内科疾病、药物和过敏状态的关联。

结果

在五年期间收到的总共1370份胆囊切除标本中,22份(1.6%)标本被诊断为嗜酸性胆囊炎。临床上,这些患者中有7例临床诊断为急性胆囊炎。患者年龄在25至64岁之间,男女比例为1:2.7。报告的最常见症状是腹痛。大多数病例在影像学上显示有胆结石(90%),而只有2例显示外周嗜酸性粒细胞增多(9%)。组织学上,72.6%的病例可见黏膜和肌肉嗜酸性粒细胞浸润。未发现与药物治疗、过敏或其他既往内科疾病有关联。

结论

嗜酸性胆囊炎是一种相对不常见的疾病,组织病理学仍是主要的诊断方法。尽管其表现可能与一般胆囊炎相似,但如果术后组织病理学诊断为嗜酸性胆囊炎,那么必须对患者进行全面检查以排除其他相关疾病,这些疾病的预后可能比胆囊炎本身更差。

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