黄甲综合征尸体解剖1例并文献复习

目的提高对黄甲综合征（YNS）临床病理的认识。方法对1例临床典型的YNS患者死后进行尸体解剖，并结合文献分析临床资料，从病理学角度初步探讨YNS的发生机制。结果YNS是一种罕见的疾病，临床主要表现黄甲、淋巴水肿、胸膜肺疾病的三联征。病理机制可能是淋巴回流障碍及毛细血管渗透性增加所致。结论黄甲综合征的诊断主要依据临床表现，在胸腔积液及蛋白丢失性肠病的鉴别诊断中应考虑到黄甲综合征的可能。胸膜活检因病变不具特异性，诊断意义不大。该病尸体解剖时，应先进行淋巴管灌注，尽可能检查肢体及胸部淋巴干的情况。

Yellow nails syndrome: an autopsied case report and review of literature

Objective To highlight the clinicopathologic characteristics of yellow nails syndrome (YNS). Methods A patient with typical yellow nail syndrome was autopsied, and related literatures were reviewed. Results YNS was an infrequent lesion and characterized by the triad of yellow nails, lymphedema, pleural and pulmonary disease. The pathogenesis may be disorder of lymphatic returning and increased osmolarity of blood capillary. Conclusion The diagnosis of YNS depends mainly on clinical manifestation. YNS should be considered in the patients showing pleural effusion or protein-losing enteropathy. Biopsy of pleura has no significance because of non-specificity. We should perfuse the lymph vessel before the necroscopy of YNS and examine the lymphatic trunks of extremity and chest as far as possible.