Baidu
map

NEJM:结节性淋巴组织增生-案例报道

2016-07-21 chenshuo 译 MedSci原创

患者女性,18岁,因出现上腹不适和反复性腹胀腹泻而来院就诊。

患者女性,18岁,因出现上腹不适和反复性腹胀腹泻而来院就诊。 




粪便检查发现存在蓝氏贾第鞭毛虫滋养体。

随即,该女患者又接受了胃镜检查,在十二指肠可见大量的结节样病变(如图A)。取活体组织检查发现,正常的绒毛固有层中淋巴滤泡与结节性淋巴样增生病变一致(如图B)。

做进一步检查评估发现,该患者患有低球蛋白血症和IgG、IgA以及IgM血清水平偏低。

根据该患者的临床症状以及检查结果,会诊医师诊断其患上了结节性淋巴组织增生性免疫缺陷病。

在临床上,患有常见变异型免疫缺陷的患者中约有20%发生结节性淋巴组织增生容易被误诊为胃肠道息肉。

结节性淋巴组织增生的发病有可能与患者经常腹泻和营养吸收不良有关,相反,其他那些没有发生腹泻和营养吸收不良症状的患者反而不容易发病。

最后,该患者接受了甲硝唑药物治疗。另外,医生告知其由于患有免疫缺陷病,因此存在很大的感染风险。

原始出处:

Vishal Sharma, M.D., D.M.Arvind Ahuja, M.D. Nodular Lymphoid Hyperplasia.N Engl J Med 2016.July 21, 2016

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=142684, encodeId=e07814268419, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Oct 09 15:56:13 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128465, encodeId=17df128465d7, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:25:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111612, encodeId=616e111612c2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:50:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693548, encodeId=da9a169354875, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Wed Nov 09 17:09:00 CST 2016, time=2016-11-09, status=1, ipAttribution=)]
    2016-10-09 1e10c84am36(暂无匿称)

    文章很好,继续关注

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=142684, encodeId=e07814268419, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Oct 09 15:56:13 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128465, encodeId=17df128465d7, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:25:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111612, encodeId=616e111612c2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:50:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693548, encodeId=da9a169354875, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Wed Nov 09 17:09:00 CST 2016, time=2016-11-09, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=142684, encodeId=e07814268419, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Oct 09 15:56:13 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128465, encodeId=17df128465d7, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:25:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111612, encodeId=616e111612c2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:50:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693548, encodeId=da9a169354875, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Wed Nov 09 17:09:00 CST 2016, time=2016-11-09, status=1, ipAttribution=)]
    2016-09-05 李东泽

    很好,不错,以后会多学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=142684, encodeId=e07814268419, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Oct 09 15:56:13 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128465, encodeId=17df128465d7, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:25:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111612, encodeId=616e111612c2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:50:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693548, encodeId=da9a169354875, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Wed Nov 09 17:09:00 CST 2016, time=2016-11-09, status=1, ipAttribution=)]

相关资讯

eLife:脂质可调节淋巴细胞能动性

淋巴组织内淋巴细胞能动性的机理目前仍然未知。由日本大阪大学和图尔库大学领导的一个研究小组首次发现,一种叫做溶血磷酸酯的脂质(LPA) 在调节淋巴结内淋巴细胞能动性上起着至关重要的作用。针对LPA及其受体可能提供新的方法来控制免疫反应。 淋巴细胞是身体的“巡逻警察”。它们的作用就是寻找入侵的病原体和异常细胞(在我们的身体内任何时候都可能出现) ,在全身的血管和淋巴管中不断“巡逻”。在寻找入侵物

应激反应或促使癌症通过淋巴系统扩散

一项基于小鼠的研究发现,应激激素通过影响淋巴系统—— 一种在全身传输组织液的网状管道,可导致癌症扩散。研究表明针对这种应激通路的疗法或有助于阻断癌细胞扩散。相关成果近日发表于《自然—通讯》。 有证据表明应激反应和癌症患者死亡的增加以及动物晚期癌症的发展有关。此前的研究表明应激激素会影响血管形成,这在疾病扩散中很重要。淋巴系统也能促进癌症扩散,但这是否受到应激反应的影响却不清楚。 澳大利亚维多利

Nat Immunol:阑尾中先天淋巴细胞(ILC)可能有巨大作用

Nature Immunology杂志最近发表的一项研究表明,阑尾在一类免疫细胞的帮助下对消化系统健康起到了关键作用。阑尾并不是多余的退化器官,而是默默做出贡献的无名英雄。Gabrielle Belz教授和Eric Vivier教授领导的研究团队发现,对于免疫系统存在缺陷的人来说先天淋巴细胞(ILC)是非常重要的。这些细胞保护阑尾避免细菌感染,帮助阑尾成为好细菌的天然“水库”,对机体健康产生重要影

Nature:CTPS1 可能是特异性淋巴细胞激活酶

来自法国的研究人员发现缺失一种叫做 CTPS1 的酶是一种人类免疫缺陷病的基础,由此阐明了代谢在人类免疫反应中的作用,并为治疗白血病一类的疾病指明了途径。相关研究论文刊登在了近期出版的《自然》(Nature)杂志上。 淋巴细胞是一类在对抗病毒及细菌等微生物中起重要作用的免疫细胞。T细胞和B细胞是淋巴细胞的两种主要类型,当存在微生物抗原分子时,这些细胞会经历一系列的分子转变诱导激活状态。这种反

ICML2013:利妥昔单抗联合苯丁酸氮芥治疗MALT淋巴瘤可延长无事件生存

一项随机Ⅲ期研究的结果显示,苯丁酸氮芥+利妥昔单抗联合治疗黏膜相关淋巴组织(MALT)淋巴瘤患者的无事件生存率和无进展生存率均优于仅接受其中一种药物治疗的患者。国际结外淋巴瘤研究组研究(IELSG-19)显示,联合治疗组131例患者的5年无事件生存率为70%,而苯丁酸氮芥单药治疗组130例患者为52%,利妥昔单抗单药治疗组132例患者为51%。联合治疗组与两个单药治疗组相比,无进展生存率也显著提高

Baidu
map
Baidu
map
Baidu
map