Medical School of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Department of Pathology, Centro Hospitalar São João, Porto, Portugal.
Virchows Arch. 2018 Sep;473(3):313-320. doi: 10.1007/s00428-018-2405-2. Epub 2018 Jul 10.
The normal density of eosinophils in the digestive mucosa of children has been rarely addressed despite being important to provide baseline counts for the diagnosis of eosinophilic gastrointestinal disorders (EGID). Histopathological criteria for EGID remain undefined and there has been little consistency of results in different populations. We aimed to establish the eosinophil density of the normal digestive mucosa in a paediatric population submitted to endoscopic procedures with normal histological features. Biopsies from endoscopies of 33 patients were evaluated. Quantification of eosinophils was performed manually. Review of the pathology reports confirmed absence of abnormality in the biopsy specimens. Counts were expressed in eosinophils per high power field and per mm. Oesophagus (n = 33): eosinophils were uniformly absent in all biopsies. Stomach: counting was performed, separately, in the superficial and deep lamina propria of the fundus (n = 13), corpus (n = 13) and antrum (n = 16). Mean eosinophilic density was higher in the deep lamina propria. Small intestine: eosinophil counts revealed 18.1 ± 17.0, 14.4 ± 12.0, and 51.5 ± 35.3 in the lamina propria of the bulb (n = 13), D2 (n = 13), and ileum (n = 16), respectively. Large intestine: the highest peak count was observed in the caecum (125 mm; n = 16) with a mean of 51.8 ± 33.5. The eosinophil counts were lower in the ascending (n = 16; 40.9 ± 27.4), transverse (n = 14; 34.3 ± 21.9), descending (n = 15; 40.0 ± 26.6), and sigmoid (n = 17; 25.8 ± 17.8) colon and in the rectum (n = 17; 13.9 ± 10.1). These data provide a baseline count and distribution of eosinophils in the gastrointestinal tract of paediatric patients with normal mucosa, thus expanding the scarce published data.
尽管嗜酸性粒细胞密度对于嗜酸粒细胞性胃肠道疾病(EGID)的诊断具有重要意义,但儿童消化黏膜中的嗜酸性粒细胞正常密度却很少被关注。EGID 的组织病理学标准仍未明确,不同人群的结果一致性也较差。我们旨在为接受内镜检查且组织学特征正常的儿科人群建立正常消化黏膜的嗜酸性粒细胞密度参考值。对 33 例患者内镜活检进行评估。嗜酸性粒细胞通过手动进行定量。病理报告的复查确认活检标本无异常。计数以每高倍视野和每毫米的嗜酸性粒细胞数表示。食管(n=33):所有活检均未见嗜酸性粒细胞。胃:分别在胃底(n=13)、胃体(n=13)和胃窦(n=16)的黏膜固有层浅层和深层进行计数。深层固有层的嗜酸性粒细胞密度较高。小肠:在十二指肠(n=13)和空肠(n=16)的黏膜固有层中,嗜酸性粒细胞计数分别为 18.1±17.0、14.4±12.0 和 51.5±35.3。大肠:在盲肠(n=16)中观察到最高的嗜酸性粒细胞计数峰值,为 125mm,平均为 51.8±33.5。升结肠(n=16;40.9±27.4)、横结肠(n=14;34.3±21.9)、降结肠(n=15;40.0±26.6)和乙状结肠(n=17;25.8±17.8)以及直肠(n=17;13.9±10.1)中的嗜酸性粒细胞计数较低。这些数据为正常黏膜的儿科患者胃肠道中的嗜酸性粒细胞提供了一个基础计数和分布,从而扩展了有限的已发表数据。
Virchows Arch. 2018-7-10
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