临床病理学在自身免疫性肝病诊治中的重要性

苗琪; 马雄

doi:10.3969/j.issn.1001-5256.2014.05.001

临床病理学在自身免疫性肝病诊治中的重要性

DOI: 10.3969/j.issn.1001-5256.2014.05.001

苗琪,
马雄

上海交通大学医学院附属仁济医院消化内科,上海市消化疾病研究所

基金项目:

国家自然基金青年项目(#81200293)；

详细信息

中图分类号: R575
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出版历程
- 收稿日期: 2014-03-25
- 出版日期: 2014-05-20

Significance of clinical pathology in diagnosis and treatment of autoimmune liver diseases

Miao Qi,
Ma Xiong

Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease

Research funding:

摘要

摘要: 肝脏组织学在自身免疫性肝病的诊断中起着重要作用,尤其是临床表现非特异、自身抗体阴性的患者。介绍了几种自身免疫性肝病在组织学上的特征性表现。自身免疫性肝炎（AIH）的特征性表现包括界面性肝炎伴淋巴-浆细胞浸润、玫瑰花环及穿入现象,而慢性非化脓性胆管炎、上皮样肉芽肿常提示原发性胆汁性肝硬化（PBC）。胆管周围洋葱皮样纤维化是原发性硬化性胆管炎（PSC）特征性表现,席纹状纤维化伴IgG4阳性浆细胞浸润常须考虑为IgG4相关硬化性胆管炎。最后指出,在日常工作中,临床医生和病理医生加强沟通有利于提高自身免疫性肝病的诊治。
- 自身免疫疾病 /
- 肝疾病 /
- 病理学,临床 /
- 组织学 /
- 述评
Abstract: Liver biopsy plays an important role in the diagnosis of autoimmune liver diseases, particularly in patients without specific clinical manifestations or negative for autoantibodies. The histological features of several autoimmune liver diseases are reviewed. The characteristic features of autoimmune hepatitis in histology include interface hepatitis with lymphoplasmacytic infiltration, hepatic rosette formation, and emperipolesis, while chronic nonsuppurative destructive cholangitis and epithelioid granuloma are frequently found in primary biliary cirrhosis. Primary sclerosing cholangitis is characterized by onion skin- like periductal fibrosis, while storiform fibrosis with IgG4- positive plasma cell infiltration often indicates IgG4- related sclerosing cholangitis. Enhanced communication between clinicians and pathologists can help improve the diagnosis and treatment of autoimmune liver diseoses.
- autoimmune diseases /
- liver disease /
- pathology clinical /
- histology /
- editorial

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参考文献(36)

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