结肠黑变病30例临床病理分析

目的 研究结肠黑变病的临床病理特点和病理性色素的性质。方法 全部病例作了临床资料主组织学观察，11全了脂褐素、黑色素、含铁血黄素和胆色素特殊染色，3例作APAAP法免疫组化染色及电镜检查，结果 结肠黑变病黏膜固有层都有棕褐色色素沉着，该色素的3旨褐素、黑色素、含铁血黄素和胆色素染色均为阴性，HMB45、B－100免疫组化染色该色素颗料亦为阴性，电镜见该色素为脂褐素样物质，结论 结肠黑变病的在很大程度上与便秘服用泻药有关，色素可能系巨噬细胞吞噬蒽醌类泻剂后形成的脂褐素样物质，它能否导致结直肠肿瘤有等进一步研究。

Melanosis Coli:A Clinicopathological Study of 30 Cases

Objective To investigate the clinic pathological features of melanosis coli and the nature of the pigment. Methods A clinical pathological study was made in all the cases.Special stains including lipofuscin,melanin,hemosiderin and bilirubin were performed in 11 cases and immunohistochemical staining of S 100 protein and HMB45 by APAAP and ultrastructural observation were made in 3 cases. Results Brown pigmentation was found in mucosa propria of melanosis coli in all cases.Staining for lipofuscin,melanin,hemosiderin and bilirubin were negative.The pigment had no reaction with S 100 protein and HMB45 antibodies.Ultrastructurally the pigment was lipofuscin like material. Conclusions Melanosis coli is strongly related to the use of laxatives in the patients with constipation.The pathologic pigment may be formed by macrophages,which phagocytose anthraquinone laxatives.Further study is needed to clarify the relationship between melanosis coli and colorectal neoplasm.