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患者男,43岁。便血伴里急后重半月余。距肛缘约3cm处有1个肿块,表面粗糙不平,质硬,触痛(±),指套血染。皮肤科情况:肛周见多枚菜花状赘生物,无不适。肠镜:距肛门3cm处见溃疡病灶,表面高低不平,有污苔,质硬,疑为直肠癌,考虑为慢性炎细胞。盆腔MRI考虑恶性肿瘤,伴周围淋巴结转移。组织病理示直肠黏膜急、慢性炎。血清TRUST 1∶4(+),TPPA(+)。诊断:梅毒性直肠炎;肛周尖锐湿疣。
Male patient, 43 years old. Blood stasis with tenesmus more than half a month later. About 3cm from the anal verge of a lump, rough surface, hard, tenderness (±), refers to sets of blood stained. Dermatology: perianal see more than one cauliflower-like vegetation, no discomfort. Enteroscopy: 3cm away from the anus at the ulcer lesions, the surface rugged, foul moss, hard, suspected colorectal cancer, considered as chronic inflammatory cells. Pelvic MRI considers malignant tumors with peripheral lymph node metastases. Histopathology showed acute and chronic rectal mucosal inflammation. Serum TRUST 1: 4 (+), TPPA (+). Diagnosis: Syphilitic proctitis; perianal genital warts.