外伤后细菌性致死性肉芽肿的透射电镜观察

目的：外伤后细菌性致死性肉芽肿是一种尚未被认识的新疾病,近20a来在我国多个地区已发现20余例,无一存活。本研究 应用透射电镜寻找病原体,为该病的诊断和治疗提供线索。方法：以透射电镜观察2例外伤后细菌性致死性肉芽肿的活检组织,寻找该病的病原。结果：病变组织内主要为组织细胞、多核巨细胞,细胞内有大量溶酶体样结构,部分溶酶体样结构具有“杆菌”形态,另见少数球菌。根据电镜下的发现成功分离出1种严格的厌氧性细菌,初步确定为放线菌,并根据细菌药敏结果救活了1例患。结论：对于怀疑由病原体所致的疾患,电镜下发现损害中的病原体是最具说服力的证据,本病的发现和命名,电镜发挥了关键作用。     

栀子的抗炎镇痛作用研究

用３．０和１．０ｇ浸膏／ｋｇ２个剂量进行试验,探讨单味桅子７５％甲醇提取物对炎症组织的影响,结果表明,桅子浸膏可显著抑制醋酸诱发血管通透性增加,高、低剂量的抑制率分别为４４．７％和２５．６％;显著抑制叉菜所致大鼠足肿胀作用,第６小时抑制率分别为３３．６％和２５．４％;显著抑制棉球肉芽组织增生,抑制率分别为５４．１％和３３．０％;对醋酸诱发的小鼠扭体反应有一定抑制作用,抑制率分别为２６．８％和１８．     

Diffuse inflammatory pseudotumor of the testis,the epididymis and the spermatic cord

Inflammatory pseudotumors have been recognized in many parts of the body. A case of a diffuse variant which involved the testis, the epididymis and the spermatic cord is described. The patient had enlarged left testis for several months. Clinically, the lesion mimicred cancer. Histologically, the lesion contained hyalinized fibrous tissue with spindle cells, plasma cells and lymphocytes. Gradual involvement of vascular channels by the cellular elements of inflammatory pseudotumor was observed. Results of immunohistochemical studies showed a myofibroblast differentiation in the majority of spindle cells: intense antibody staining for smooth muscle actin, muscle specific actin, and vimentin. The ultrastructural findings, intracytoplasmic filaments with dense bodies, were also consistent with the myofibroblastic nature of these cells. The histiocyte differentiation of spindle cells is questionable in our case, because only scattered histiocyte-like cells showed positivity with the KP-1 (CD-3) antibody.     

Diagnosis of cerebral Whipple's disease by cerebrospinal fluid cytology

Summary In a case of Whipple's disease the diagnosis was made by careful cytologic evaluation of the cerebrospinal fluid (CSF), identifying Sieracki cells. A basal granuloma invaded the hypothalamus, diencephalon, and rostral parts of the brainstem. An exploration in the initial stage led to misdiagnosis as a granular cell tumor. Diagnosis was then confirmed by intestinal biopsy.

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Zusammenfassung Es wird über einen Fall mit Morbus Whipple berichtet, der bei sorgfältiger Untersuchung des Liquor cerebrospinalis durch den Nachweis von Sieracki-Zellen diagnostiziert wurde. Die Exploration eines basalen Granuloms, das in den Hypothalamus, das Diencephalon und die rostralen Anteile des Hirnstamms eingewachsen war, hatte im Frühstadium zur Fehlinterpretation eines Granularzelltumors geführt. Die Diagnose wurde schließlich durch Dünndarmbiopsie bestätigt.

     

骨嗜酸性肉芽肿临床病理分析

作者回顾性分析２６例骨嗜酸性肉芽肿的病理肉眼镜了改变，着重探讨其组织病理特点，指出本病性质属良性非肿瘤性病变，认为骨嗜酸性肉芽肿的病理分期有利于病理诊断及指导临床治疗，并提出病理活检在该病的诊断中有重要意义。     

儿童嗜酸性淋巴肉芽肿的临床特点与治疗

目的 探讨儿童嗜酸性淋巴肉芽肿（ELG）的临床特点和诊治方法，以提高对本病的认识。方法 回顾性分析5例ELG患儿的临床特征、实验室检查、病理、治疗及疗效，并进行相关文献复习。结果 ELG5例均为男童，主要表现为多发性皮肤软组织肿块和淋巴结大，其中1例并肾病综合征，2例有反复湿疹样皮疹，1例2次发生喘息性支气管炎，患儿均无肝脾大，生长发育良好。最初单纯化疗4例均复发，经配合局部放疗或加用环孢素（CsA）等治疗后未复发。结论 儿童ELG临床及病理特点与成人相似，但儿童发病较少。单纯化疗易复发，配合放疗、手术、应用CsA等综合治疗可提高疗效。     

Chronological observation of surgically‐treated granuloma faciale implies the necessity of circumspect management for perinasal nodular subset

Granuloma faciale (GF) is a rare chronic dermatosis with still unknown etiopathology, which usually presents a solitary, asymptomatic, smooth reddish‐brown to violaceous plaques or nodules on the face. Various therapeutic approaches, including topical application of corticosteroid or tacrolimus and removal with laser, cryotherapy and surgery have been attempted; however, the outcome has been inconsistent. Herein, we report a case of perinasal nodular GF who repeatedly underwent surgical excisions after the failure of laser treatment. Despite its nomenclature, GF does not manifest granulomatous tissue and the lesion is histopathologically characterized by dense dermal cell infiltration devoid of granulomatous changes and not distinguished by a clear border, which partially explains the difficulty of complete removal in our case. Review of the published work delineated that GF could be largely divided into two clinical subsets: plaque and nodular types. The plaque type GF could be responsive to topical tacrolimus, an approach preferentially adopted nowadays, while nodular type GF was often resistant to topical therapies and required surgical or laser removal. The latter subset often arose around the nose. For this location, surgical excision with sufficient removal margin is sometimes technically difficult when an aesthetically acceptable outcome is expected, explaining the basis for local recurrence. Postoperative recurrence could be observed after years of disease‐free period. These observations indicated that the need for respective treatment strategies for the management of distinctive GF subsets. Of note, a multidisciplinary approach combining radical resection and additional supportive intervention with long‐term follow up may be required for perinasal and nodular GF.