论文部分内容阅读
目的分析结核相关性脂膜炎的临床及组织病理特点,探讨结核感染与脂膜炎发病的关系。方法回顾性分析我科2011年1月—2013年8月252例组织病理明确诊断为脂膜炎的患者临床及组织病理资料,并根据结核菌素皮试(TST)结果及其阳性反应级别分为PPD阴性组及PPD阳性组,其中PPD阳性组又分为PPD 1+、PPD 2+、PPD 3+3组。再根据T-SPOT.TB结果分为T-SPOT.TB阴性组及T-SPOT.TB阳性组,对比分析各组间患者临床及组织病理特点。结果 PPD阳性组与PPD阴性组患者组织病理改变在表皮、脂肪层受累、炎性浸润细胞类型、有无上皮样肉芽肿方面对比差异具有统计学意义(P<0.05);不同PPD阳性级别组患者的组织病理特点差异无统计学意义(P>0.05);T-SPOT.TB阴性组与阳性组患者组织病理改变差异无统计学意义(P>0.05)。结论皮肤脂膜炎的发病与结核感染密切相关,PPD检测阳性及皮损组织病理中出现脂肪层以小叶受累或混合型炎症、以上皮样和(或)多核巨细胞浸润为主以及上皮样肉芽肿是脂膜炎与结核感染相关的线索。
Objective To analyze the clinical and histopathological features of tuberculosis-associated panniculitis and explore the relationship between tuberculosis infection and the incidence of panniculitis. Methods The clinical and histopathological data of 252 patients with histopathological diagnosis of panniculitis from January 2011 to August 2013 were retrospectively analyzed. According to the results of tuberculin skin test (TST) and their positive reaction grade PPD negative group and PPD positive group, in which PPD positive group is divided into PPD 1 +, PPD 2 +, PPD 3 + 3 group. According to the results of T-SPOT.TB, the patients were divided into T-SPOT.TB negative group and T-SPOT.TB positive group. The clinical and histopathological features of the patients were compared. Results The histopathological changes of PPD-positive group and PPD-negative group were statistically significant (P <0.05) in the epidermis, fat layer involvement, inflammatory infiltration cell type, with or without epithelioid granuloma (P <0.05) (P> 0.05). There was no significant difference in histopathological changes between T-SPOT.TB negative group and positive group (P> 0.05). Conclusion The incidence of dermatitis is closely related to tuberculosis infection. Positive PPD and pathological changes of the lesion include lobular involvement or mixed inflammation, epithelial-like and / or multinucleated giant cell infiltration and epithelial-like granulation Swollen is a clue to the association of panniculitis with tuberculosis.