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一名年轻健康成年人阑尾的软斑病:病例报告及文献综述

Malakoplakia of the appendix in a young healthy adult: a case report and literature review.

作者信息

Pastena Dario, Giambusso Mauro, Castri Federica, Potenza Angelo Eugenio, Caprino Paola, Sacchetti Franco, Sofo Luigi

机构信息

Division of Abdominal Surgery, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Division of General Pathological Anatomy, Department of Women's and Child Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

出版信息

J Surg Case Rep. 2022 Aug 4;2022(8):rjac357. doi: 10.1093/jscr/rjac357. eCollection 2022 Aug.

Abstract

Malakoplakia is a rare entity on inflammatory base that mostly occurs in immunocompromised individuals which is thought to be secondary to a bactericidal defect in macrophages. The genitourinary tract is typically affected. The appendix is a very rare localization. We report a case of malakoplakia in the appendix of a young healthy patient with a recent history of abdominal pain associated with diarrhea and nausea. The colonscopy and CT scan showed an extramucosal bumping mass pressing on the cecum and covered by normal mucosa. The patient underwent to laparoscopic appendectomy. The histology showed a malakoplakia of the appendix. Gastrointestinal localization of malakoplakia is often associated with preexisting diseases, which are probably responsible for an immune disorder underlying the etiopathogenesis of the disease. However, in our case, the patient had no comorbidities. Probably, a clinically unknown immune predisposition plays an important role. Further studies are needed to clarify this nexus.

摘要

软斑病是一种罕见的以炎症为基础的病症,主要发生在免疫功能低下的个体中,被认为是巨噬细胞杀菌缺陷的继发结果。泌尿生殖道是典型的受累部位。阑尾是非常罕见的发病部位。我们报告一例年轻健康患者阑尾发生软斑病的病例,该患者近期有腹痛伴腹泻和恶心病史。结肠镜检查和CT扫描显示一个黏膜外突出肿物压迫盲肠,表面覆盖正常黏膜。患者接受了腹腔镜阑尾切除术。组织学检查显示阑尾软斑病。软斑病的胃肠道发病部位常与既往疾病相关,这些疾病可能是该疾病发病机制潜在免疫紊乱的原因。然而,在我们的病例中,患者没有合并症。可能一种临床上未知的免疫易感性起了重要作用。需要进一步研究来阐明这种联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/904d/9352265/960966c8fe2a/rjac357f1.jpg

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