Yao T, Nagai E, Utsunomiya T, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Surg Pathol. 1995 Sep;19(9):1054-60. doi: 10.1097/00000478-199509000-00009.
Pyogenic granuloma is a common disease in the skin, but it is extremely rare in the gastrointestinal tract except for the oral cavity. We have seen three lesions (from three patients) of an intestinal counterpart of pyogenic granuloma and have reviewed their clinicopathologic features. Macroscopically, all three lesions revealed a polypoid growth with either a sessile or pedunculated configuration. All had an ulceration on the top. Microscopically, all these lesions were composed of a lobular proliferation of varying sizes of capillaries with an edematous stroma. Endothelial cells of the capillaries were swollen variously and in one case revealed a few mitotic figures. An inflammatory process was associated with the presence of ulcerations. Immunohistochemically, both Factor VIII-related antigen and QB-end/10(CD34) were positive only for the endothelial cells in all three cases. The characteristic macroscopic and histologic features thus allow for an early diagnosis of pyogenic granuloma in the gastrointestinal tract, which is similar to that observed in the skin.
化脓性肉芽肿是一种常见的皮肤疾病,但除口腔外,在胃肠道极为罕见。我们见过三例(来自三名患者)肠道化脓性肉芽肿样病变,并对其临床病理特征进行了回顾。宏观上,所有三个病变均呈息肉样生长,有蒂或无蒂。顶部均有溃疡。微观上,所有这些病变均由大小不等的毛细血管小叶状增生和水肿性间质组成。毛细血管内皮细胞不同程度肿胀,其中一例可见少量有丝分裂象。炎症过程与溃疡的存在有关。免疫组化显示,三例中VIII因子相关抗原和QB-end/10(CD34)均仅在内皮细胞呈阳性。这些特征性的宏观和组织学表现有助于早期诊断胃肠道化脓性肉芽肿,其与皮肤所见相似。