Emanuelli G, Calcamuggi G, Cestonaro G, Gatti G, Brunello F
Schweiz Med Wochenschr. 1979 Apr 14;109(15):562-5.
A 27-year-old woman presented with high spiking fevers, progressive malaise, weight loss, and marked hepatosplenomegaly. The clinical picture and laboratory findings (including hepatic scintiscan, coeliac arteriography and abdominal lymphangiography) prompted surgical exploration of hypochondriac organs. On laparotomy, both liver and spleen surface exhibited extensive inflammatory lesions. Histopathologic investigations on hepatic tissue showed microscopic caseating granulomata. Specific stains and cultures for mycobacterium, fungi etc. were negative in tissue preparations. Antituberculous and steroid therapy elicited a rapid response. Follow-up observations indicated the resolution of specific hepatic lesions.
一名27岁女性出现高热、进行性不适、体重减轻及明显的肝脾肿大。临床症状和实验室检查结果(包括肝脏闪烁扫描、腹腔动脉造影和腹部淋巴管造影)促使对季肋部器官进行手术探查。剖腹手术时,肝脏和脾脏表面均呈现广泛的炎性病变。肝组织的组织病理学检查显示有显微镜下的干酪样肉芽肿。组织标本中针对分枝杆菌、真菌等的特殊染色和培养均为阴性。抗结核和类固醇治疗引起了快速反应。随访观察表明特异性肝脏病变已消退。