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目的探讨脑弓形虫病临床病理学特征、诊断及鉴别诊断。方法对2例脑弓形虫病进行病理形态学观察及免疫组化标记,并复习相关文献。结果 2例均可见脑胶质细胞增生、慢性炎细胞浸润、巨噬细胞反应伴血管炎及血管周围炎。其中1例脑组织大片坏死,增生的胶质细胞和慢性炎细胞构成肉芽肿结构。2例病灶内均找到弓形虫病原体。免疫组化:弓形虫特异性抗体(+)。结论脑弓形虫病在后天获得性弓形虫病中较常见。病灶中确认弓形虫病原体最具诊断意义,可为临床诊断及治疗提供可靠依据。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of toxoplasmosis of the brain. Methods Two cases of Toxoplasma gondii were observed by pathomorphology and immunohistochemistry, and the relevant literature was reviewed. Results Two cases showed glomerular hyperplasia, chronic inflammatory cell infiltration, macrophage reaction with vasculitis and perivascular inflammation. One case of large brain tissue necrosis, hyperplastic glial cells and chronic inflammatory cells constitute granuloma structure. Toxoplasma gondii pathogen was found in 2 cases. Immunohistochemistry: Toxoplasma gondii-specific antibody (+). Conclusion Toxoplasmosis is more common in acquired acquired toxoplasmosis. Toxoplasma gondii confirmed in the most pathogenic pathogen diagnosis, clinical diagnosis and treatment can provide a reliable basis.