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脊柱结核的临床形态学方面

Clinical-Morphological Aspects in Spinal Tuberculosis.

作者信息

Procopie I, Popescu E L, Pleșea R M, Dorobanțu M, Mureșan R F, Lupașcu-Ursulescu C V, Pleșea I E, Anușca D N

机构信息

Doctoral School, University of Medicine and Pharmacy of Craiova, Romania.

Department of Orthopaedics and Traumatology, Clinical CF Hospital of Craiova, Romania.

出版信息

Curr Health Sci J. 2018 Jul-Sep;44(3):250-260. doi: 10.12865/CHSJ.44.03.08. Epub 2018 Jul 15.

Abstract

UNLABELLED

Osteoarticular tuberculosis (OATB) Aim: The authors made a clinical morphological assessment of tissue samples from patients admitted in Surgical Departments of the Emergency County Hospital of Craiova, Romania, between 1990 and 2015, proved as presenting tuberculous lesions of the spine in the Department of Pathology of the same Hospital.

MATERIALS AND METHODS

The studied material consisted of bone, joint and sometimes muscle tissue fragments resulted from biopsies or surgical excisions from 7 cases coming out of 54 patients investigated in the above-mentioned period of time, where the established histological diagnosis was tuberculosis (TB). For diagnostic confirmation, Ziehl-Neelsen staining has been used as a rule but, in some cases, immunohistochemistry was also used.

RESULTS

TB lesions have prevailed in men and around the age of 50 years. Thoracic segment of the spine was the most involved. Epithelioid and giant Langhans cells dominated the inflammatory cellular population. Necrosis was always present, usually in its classical acidophilic form. Fibrosis was almost always absent. On the whole, the granulomatous reaction was in almost half of the cases hyporeactive and disorganized.

CONCLUSIONS

The clinical morphological profile of our series is fitting with data described in the literature. Because of its life threatening potential, spinal TB should be investigated thoroughly especially in its morphological features in order to obtain as quickly as possible an etiological diagnosis.

摘要

未标注

骨关节结核(OATB)

目的

作者对1990年至2015年间在罗马尼亚克拉约瓦县急诊医院外科住院的患者的组织样本进行了临床形态学评估,这些样本在同一家医院的病理科被证实存在脊柱结核病变。

材料与方法

研究材料包括7例患者活检或手术切除所得的骨、关节及有时肌肉组织碎片,这7例患者来自上述时间段内接受调查的54例患者,其组织学诊断为结核病(TB)。通常采用齐-尼氏染色进行诊断确认,但在某些情况下也使用免疫组织化学方法。

结果

TB病变在男性及50岁左右人群中更为常见。脊柱胸段受累最为严重。上皮样细胞和朗汉斯巨细胞在炎性细胞群体中占主导。坏死总是存在,通常呈典型的嗜酸性形式。几乎总是不存在纤维化。总体而言,近一半病例的肉芽肿反应低下且结构紊乱。

结论

我们系列研究的临床形态学特征与文献中描述的数据相符。由于脊柱结核具有潜在的生命威胁,应进行全面调查,尤其是其形态学特征,以便尽快获得病因诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b81a/6311224/2f82728b496d/CHSJ-44-03-08-fig1.jpg

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