Asakura H, Tsuchiya M, Katoh S, Kobayashi K, Yonei Y, Yoshida T, Hamada Y, Miura S, Morita A, Kuramochi S
Gastroenterology. 1986 Sep;91(3):719-24. doi: 10.1016/0016-5085(86)90644-x.
Lymphangiectasia of the large intestine associated with protein-losing enteropathy is reported. A 33-yr-old man suffered from diarrhea, sometimes mixed with blood. Colonoscopic study revealed reddish and edematous mucosa with multiple flat elevated lesions and giant folds in the localized segment of the rectosigmoid. An intestinal clearance test of alpha 1-antitrypsin revealed the association of protein-losing enteropathy. Operation was performed successfully, resulting in a marked improvement of symptoms and laboratory data, especially serum total protein, albumin, IgG, and Leu-2a-positive cells (suppressor/cytotoxic T cells). Giant folds consisted of the submucosal edema and hyperplasia of the epithelial glands with cystic dilatation of glands, and flat elevated lesions consisted of mucosal and submucosal edema associated with intestinal lymphangiectasia, adipose tissue, and blood capillaries. The population of the Leu-2a-positive cells in the lamina propria and intraepithelial layer was decreased and that of the Leu-3a-positive cells (helper/inducer T cells) in the lamina propria was increased.
报告了一例与蛋白丢失性肠病相关的大肠淋巴管扩张症。一名33岁男性患有腹泻，有时伴有便血。结肠镜检查显示，在直肠乙状结肠局部节段，黏膜呈红色且水肿，有多个扁平隆起病变和巨大皱襞。α1-抗胰蛋白酶的肠道清除试验显示存在蛋白丢失性肠病。手术成功实施，症状和实验室数据，尤其是血清总蛋白、白蛋白、IgG和Leu-2a阳性细胞（抑制/细胞毒性T细胞）有显著改善。巨大皱襞由黏膜下水肿、上皮腺体增生伴腺体囊性扩张组成，扁平隆起病变由与肠道淋巴管扩张、脂肪组织和毛细血管相关的黏膜和黏膜下水肿组成。固有层和上皮内层中Leu-2a阳性细胞数量减少，固有层中Leu-3a阳性细胞（辅助/诱导T细胞）数量增加。
