病理学课件-肠炎

第三节非特异性肠炎局限性肠炎慢性溃疡性结肠炎、局限性肠炎((Crohn病)又称克罗恩病、克隆氏病一)定义:是一种病因未明的主要侵犯消化道的全身性疾病(二)常见人群:20-30岁青年三)好发部位:回肠末端>结肠>回肠近端>空肠等(四)病因、发病机制:免疫、遗传、感染有关(五)病理变化肉眼观:病灶呈节段性分布病变处粘膜高度水肿增厚呈卵石状粘膜面有裂隙状溃疡(深、长)→穿孔、肠瘘病变肠壁因纤维化而增厚、变硬、肠腔狭窄可与邻近肠管发生粘连crohη病发生在小肠。黏膜表面有不规则的充血结节和浅表溃疡灶ThisisanotherexampleofCrohnsdiseaseinvolvingthesmallintestine.Here,themucosalsurfacedemonstratesanirreqularnodularappearancewithhyperemiaandfocalsuperficialulceration光镜下:裂隙状溃疡,表面被覆坏死组织穿壁性炎症:肠壁全层慢性炎症,有淋巴滤泡形成粘膜下层淋巴管高度扩张,有严重的淋巴水肿50%-70%病例肠壁有结核样肉芽肿形成何见类上皮细胞和多核巨细胞,但无干酪样坏死indef.eoCrohn病并发症瘘管。左边可见裂缝从黏膜延伸到黏膜下层、肌层,最终形成瘘管瘘管可在肠袢间、膀胱和皮肤形成。累及结肠的直肠周瘘管常见OnecomplicationofCrohn,sdiseaseisfistulaformationSeenhereisafissureextendingthroughmucosaattheleftintothesubmucosatowardthemuscularwallwhicheventuallywillformafistulaFistulaecanformbetweenloopsofbowelbladder,andskin.Withcolonicinvolvement,perirectalfistulaearecommon疲理学品雌inglisxteGop显微镜下Crohnη病的特点是穿壁性炎症。炎细胞(兰色浸润)从黏膜层到黏膜下层、肌层均有浸润,在浆膜表面苍白的肉芽肿中心出现结节性浸润Microscopically,Crohn,sdiseaseischaracterizedbytransmuralinflammationHere,inflammatorycells(thebluishinfiltrates)extendfrommucosathroughsubmucosaandmuscularisandappearasnodularinfiltratesontheserosalsurfacewithpalegranulomatouscentersCrohn病炎性肉芽肿,有上皮样细胞、巨细胞和许多淋巴细胞。微生物特殊染色阴性AthighmagnificationthegranulomatousnatureoftheinflammationofCrohn'sdiseaseisdemonstratedherewithepithelioidcells,giantcells,andmanylymphocytes.Specialstainsforor