猫抓病2例临床病理分析

目的 探讨猫抓病的临床病理学特征、诊断及鉴别诊断.方法 对2例猫抓病进行临床病理分析,应用Warthin-Starry嗜银纤维染色进行诊断和鉴别诊断.结果 2例猫抓病患者,1例有明确的被猫咬伤手指史,1例可疑被猫抓咬病史.镜下见大量淋巴结构破坏,多发性、大小不一的圆形结节性肉芽肿性病变.结节中央为含嗜中性粒细胞的中心性坏死,其间见少量类上皮细胞、多核巨细胞等.肉芽肿性结节为非干酪样坏死性.Warthin-Starry嗜银纤维染色发现结节内有大量阳性杆菌.结论 猫抓病常见的病原体为巴尔通氏体,其淋巴结肉芽肿的病理组织学变化酷似性病性淋巴肉芽肿、非干酪性结核等.可根据临床病史、特殊皮肤试验、病理组织学改变及嗜银纤维染色来加以诊断和鉴别诊断.

Clinical pathologic analysis of the eat-scratch diseases

Objiective To explore clinical pathologic characteristics, diagnosis and differential diagnosis of the cat-scratch diseases. Methods 2 patients with cat-scratch diseases were analyzed by histological observation and Warthin-Starry argentaffine fibers stain. Results One patient had a clearly medical history bitten finger by a roam a-bout cat. Histologically, the nodular was composed of epithelioid cells, multinuclear giant cells with a central necrot-ic. Conclusions The common etiology of the cat-scratch disease were Bartonella hensellae. These lesions greagly re-semble those of lymphogranuloma venereum and non-caseous tuberculosis. The diagnosis and differential diagnosis was based on the history, a specific cutaneous test and Warthin-Starry argentaffine fibers stain.