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伪装成局部晚期结直肠恶性肿瘤的结肠黏膜包涵体病的外科挑战:病例报告。

A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy-A Case Report.

机构信息

Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University of Galați, 800201 Galați, Romania.

Surgical Clinical Department, "Sf. Apostol Andrei" Emergency Clinical County Hospital, 800578 Galați, Romania.

出版信息

Medicina (Kaunas). 2023 Jan 12;59(1):156. doi: 10.3390/medicina59010156.

Abstract

Colonic malakoplakia is an uncommon granulomatous development of cells resulting from the impaired capacity of the mononuclear cells to eliminate the phagocytosed bacteria, and in rare cases it can also affect the gastrointestinal tract. We report the case of a 78-year-old female patient that was admitted to hospital by The Emergency Department with the diagnosis of bowel obstruction, confirmed by the clinical and paraclinical investigations. We decided to surgically manage the case for suspicious symptomatic colonic neoplasm. The histological examination of the surgical specimens revealed colonic malakoplakia, characterized by the presence of the aggregated granular histiocytes and Michaelis-Gutmann bodies. Through this paper, we want to raise awareness for Malakoplakia, which remains an extremely rare disease that may affect multiple organs, and because it does not present specific symptoms or clinical manifestations, the final diagnosis remains the histopathological study. The clinical conduct should be decided after taking into consideration all the aspects of this pathology along with the benefits and risks for the patient.

摘要

结肠黏膜黑色素沉着症是一种罕见的细胞肉芽肿性疾病,是由于单核细胞清除吞噬细菌的能力受损所致,在极少数情况下也会影响胃肠道。我们报告了一例 78 岁女性患者的病例,该患者因疑似症状性结肠肿瘤而被收入我院急诊科。我们决定通过手术来治疗该患者。临床和影像学检查均证实存在肠梗阻。手术标本的组织学检查显示为结肠黏膜黑色素沉着症,特征为聚集的颗粒状组织细胞和米氏小体。通过本文,我们希望提高对黏膜黑色素沉着症的认识,这种疾病极其罕见,可能影响多个器官,而且由于它没有特定的症状或临床表现,最终诊断仍需依靠组织病理学研究。临床决策应在综合考虑该病理学的各个方面以及对患者的益处和风险后作出。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c426/9860922/ccc1c76aff09/medicina-59-00156-g005.jpg

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