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目的探讨椎管内丝虫病的临床病理学特点,诊断与鉴别诊断。方法应用HE染色、特殊染色和免疫组化染色对1例椎管内丝虫病的组织形态进行观察,并结合国内外文献讨论该病的临床及病理特点。结果患儿男性,3岁。以突发性颈部疼痛伴高热为主要表现。MRI检查示颈4~6椎体水平椎管内占位。手术摘除肿物。镜下显示为炎性肉芽肿性病变伴大量嗜酸性粒细胞、淋巴细胞、浆细胞及多核巨细胞反应,部分病变中心区可见线状虫体以及微丝蚴;PAS特染阳性。病理诊断为寄生虫性肉芽肿。结论椎管内丝虫病实属罕见病例,文献中也仅有数例报道,发生在儿童且伴有高热极易误诊,需在鉴别诊断时加以考虑。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of filariasis in the spinal canal. Methods HE staining, special staining and immunohistochemical staining were used to observe the histological changes of one case of filariasis. The clinical and pathological features of this disease were discussed in combination with literature from home and abroad. Results children male, 3 years old. With sudden neck pain with high fever as the main performance. MRI examination showed cervical 4 ~ 6 vertebral body vertebral level. Surgical removal of the tumor. Microscope showed inflammatory granulomatous lesions with a large number of eosinophils, lymphocytes, plasma cells and multinucleated giant cell response, some lesions in the central area visible filariasis and microfilaria; PAS-positive staining. Pathological diagnosis of parasitic granuloma. Conclusion The filariasis in the spinal canal is a rare case. There are only a few cases reported in the literature. Children with hyperthermia are easily misdiagnosed and need to be considered in the differential diagnosis.