Lymphocytic infiltration yog ib qho mob dermatosis uas tsis tshua muaj tshwm sim los ntawm benign infiltration ntawm daim tawv nqaij nrog lymphocytes. Pathology muaj cov chav kawm undulating thiab nyiam daws nws tus kheej. Clinically, nws manifests nws tus kheej raws li ib tug pob khaus ntawm cov tawv nqaij ntawm du, tiaj tus, xiav-liab papules los yog plaques uas sib koom ua ke rau hauv hnab ris txog qhov loj ntawm xibtes.
Cov ntsiab lus tseem ceeb muaj ciam teb meej, tuaj yeem tev tawm. Plaques feem ntau yog ib leeg, thaj chaw ntawm lub ntsej muag, lub cev, caj dab, caj dab. Tus kab mob no tau kuaj pom nrog kev lees paub histological, hauv qee kis, kev tshuaj xyuas molecular biological tau ua. Kev kho mob ntawm pathology muaj nyob rau hauv kev siv cov tshuaj hormones, NSAIDs, tshuaj pleev ib ce.
Kev piav qhia ntawm kab mob no
Lymphocytic infiltrationNws yog ib tug benign pseudolymphoma ntawm daim tawv nqaij nrog ib tug ntev recurrent undulating chav kawm. Nws yog qhov tsawg heev thiab feem ntau tshwm sim hauv cov txiv neej tom qab 20 xyoo. Tus kab mob no tsis muaj kev sib txawv ntawm haiv neeg thiab lub caij nyoog, nws tsis yog qhov kawg. Qee zaum yuav muaj kev txhim kho ntawm tus neeg mob lub caij ntuj sov.
Thawj hais txog tus kab mob
Thawj zaug tus kab mob no tau piav qhia hauv cov ntaub ntawv kho mob hauv xyoo 1953, thaum N. Kanof thiab M. Jessner suav tias nws yog cov txheej txheem kev ywj pheej nrog los ntawm kev nkag mus ntawm txhua daim tawv nqaij los ntawm lymphocytes. Lub npe "pseudolymphoma" tau qhia los ntawm K. Mach, uas ua ke Jessner-Kanof infiltration rau hauv ib pawg nrog lwm hom lymphocytic infiltration.
Xyoo 1975, O. Brown tau sib txawv ntawm cov txheej txheem pathological thiab suav tias qhov kev nkag mus rau B-cell pseudolymphomas, tab sis me ntsis tom qab, cov kws kho mob pib xav txog tus kab mob no li T-pseudolymphoma, vim nws yog T-lymphocytes uas. muab ib tug benign chav kawm ntawm pathology thiab muaj peev xwm ntawm involuntary involutions ntawm thawj lub ntsiab. Cov kev tshawb fawb tom qab tau pom tias kev tiv thaiv kab mob ua lub luag haujlwm tseem ceeb hauv kev txhim kho lymphocytic infiltration, uas tej zaum yuav yog vim qhov tseeb tias lub cev tiv thaiv kab mob nyob hauv txoj hnyuv, thiab nws txoj kev swb yog pom hauv 70% ntawm cov neeg mob. Kev tshawb fawb ntawm pathology txuas ntxiv mus rau hnub no. Kev nkag siab txog cov laj thawj ntawm kev txhim kho T-lymphoid txheej txheem yog qhov tseem ceeb hauv kev txhim kho cov kab mob pathogenetic rau pseudolymphomas.
theemmuaj kab mob
Tus kab mob no muaj ntau theem ntawm kev loj hlob, uas yog tus cwj pwm los ntawm qhov hnyav ntawm cov txheej txheem pathological. Yog li sawv tawm:
- Kev tawg ntawm lymphoplasmacytic infiltration. Nrog nws, cov tsos mob ntawm tus kab mob no tsis tseem ceeb thiab mob me.
- Ntaus lymphoplasmacytic infiltration. Kev tsim ntawm ib qho kev tsom xam ntawm cov pob liab liab yog pom.
- mob hnyav lymphoplasmacytic infiltration. Qhov no yog dab tsi? Nws yog tus yam ntxwv los ntawm kev tsim ntawm ntau foci thiab qhov txhab.
Ua rau kab mob
Qhov ua tau ntau tshaj plaws ntawm kev loj hlob ntawm focal lymphoplasmacytic infiltration yog suav tias yog zuam tom, hyperinsolation, ntau yam kab mob, pathologies ntawm lub plab zom mov, kev siv cov tshuaj pleev ib ce dermatogenic thiab kev siv tshuaj tsis tsim nyog uas ua rau muaj kev hloov pauv hauv lub cev., Externally sawv cev los ntawm infiltrative mob nyob rau hauv daim tawv nqaij.
Lub txheej txheem ntawm kev loj hlob ntawm lymphocytic infiltration yog cov txheej txheem hauv qab no: cov epidermis tsis zoo muab T-lymphocytes nrog lub sijhawm los nkag mus rau hauv cov txheej txheem sib sib zog nqus ntawm daim tawv nqaij, nyob ib ncig ntawm choroid plexuses thiab hauv papillary outgrowths thoob plaws tag nrho cov tuab. ntawm daim tawv nqaij. Pathology ua rau cov txheej txheem inflammatory, uas cov tawv nqaij thiab lub cev tiv thaiv kab mob tshwm sim ncaj qha. T-lymphocytes muaj nyob rau hauv cov txheej txheem ntawm kev tshem tawm xws li mob, uas muab ib tug benign tiv thaiv kab mob nyob rau hauv daim ntawv ntawm proliferation ntawm daim tawv nqaij epithelial hlwb.
theeminflammatory txheej txheem
Tib lub sijhawm, kev mob tshwm sim, uas dhau los ntawm peb theem: hloov pauv, exudation thiab proliferation nrog kev koom tes ntawm cov ntaub so ntswg reticular (histocytes). Cov hlwb no pawg thiab tsim cov Islands tuaj uas zoo li lymphoid follicles. Nyob rau theem kawg ntawm kev tso tseg cov tshuaj tiv thaiv kab mob, ob qho tib si txheej txheem ntawm kev loj hlob ntxiv thiab ntxiv rau ib leeg. Yog li, foci ntawm pathology tshwm sim.
Vim cov lymphocytes yog heterogeneous, qhov kev ntsuam xyuas ntawm lawv cov khoom siv histochemical siv cov tshuaj tiv thaiv kab mob monoclonal thiab cov cim tiv thaiv kab mob ua rau lub hauv paus ntawm immunophenotyping. Qhov kev tshuaj ntsuam no muaj qhov tseem ceeb hauv kev kuaj mob dermatology.
Ntau yam xav paub tias nws yog dab tsi - lymphoplasmacytic infiltration ntawm plab thiab hnyuv?
Kev mob plab hnyuv
Mob tuaj yeem qhia tau ntau yam. Nyob rau hauv cov ntaub ntawv no, cov qog yog shortened, lawv ceev yog ho txo. Nrog lymphoplasmacytic infiltration nyob rau hauv lub stroma, muaj ib tug pronounced nce nyob rau hauv reticulin fibers thiab hyperplasia ntawm du leeg phab ntsa. Cov kab mob gastritis ntev tuaj yeem suav tias rov qab tau yog tias, tom qab kev kho mob, qhov kev nkag mus ploj mus, rov ua kom cov qog atrophied thiab rov ua dua tshiab ntawm tes.
Cov txheej txheem tseeb ntawm qhov pib ntawm hom B gastritis hauv lymphomacytic infiltration ntawm lub plab tseem tsis meej txaus. Etiological yam uas ua rau kev loj hlob ntawm cov kab mob gastritis ntev feem ntau muab faib ua endogenous thiab exogenous.
Kev nkag musplab
Nrog rau tus kab mob no, nkag mus rau hauv cov ntaub so ntswg sib txuas thiab cuam tshuam kev ua haujlwm ntawm lub plab tsis yog xwb, tab sis kuj tseem muaj lwm cov plab hnyuv siab raum. Lawv kuj muaj xws li lymphocytic colitis, uas yog ib tug kab mob inflammatory ntawm txoj hnyuv nrog lymphoplasmacytic infiltration ntawm mucous daim nyias nyias. Hom kab mob colitis no yog tshwm sim los ntawm qhov tshwm sim ntawm qhov mob raws plab nrog rau kev kawm ntev. Kev kho tus kab mob no tshwj xeeb, raws li kev siv tshuaj los tawm tsam cov hauv paus hauv paus ntawm nws txoj kev loj hlob, nrog rau cov tsos mob, tshem tawm raws plab thiab normalize plab hnyuv microflora.
Symptomatics
Qhov pib ntawm daim tawv nqaij pob khaus nrog lymphocytic infiltration yog lub tiaj tus loj paj yeeb-cyanotic plaque los yog papule nrog cov qauv meej meej thiab ib qho chaw du, uas muaj kev nyiam rau peripheral kev loj hlob. Kev sib koom ua ke nrog ib leeg, cov ntsiab lus tseem ceeb tsim arcuate lossis annular Islands tuaj nrog thaj tsam ntawm tev. Qhov kev daws teeb meem ntawm cov ntsiab lus pathological pib, raws li txoj cai, los ntawm qhov chaw, vim tias qhov sib txuam foci tuaj yeem muaj kev poob qis hauv qhov nruab nrab. Qhov chaw hauv zos yog lub ntsej muag, caj dab, qhov chaw parotid, nraub qaum ntawm lub taub hau, lub puab tsaig, hauv pliaj thiab cheekbones. Qee zaum, pob khaus tuaj yeem pom ntawm daim tawv nqaij ntawm caj dab thiab lub cev. Feem ntau lub hauv paus tseem ceeb yog ib leeg, ib qho kev nyiam rau kev sib kis ntawm cov txheej txheem pathological yog me ntsis tsis tshua pom.
Stroms
Stomas feem ntau tsim nyob rau hauv thaj tsam ntawm lub plab, hnyuv, hnyuv, uas yog cov ntaub so ntswg reticular (interstitium), peb-dimensional fine-loop network. Lymphatic thiab cov hlab ntsha hla dhau stroma.
Lymphocytic infiltration yog tus cwj pwm los ntawm cov chav kawm undulating. Tus kab mob no tiv taus kev kho mob tsis tu ncua, muaj peev xwm ntawm tus kheej kho tus kheej. Relapses feem ntau tshwm sim nyob rau hauv qhov chaw ntawm yav dhau los localization, tab sis lawv kuj tuaj yeem ntes cov chaw tshiab ntawm epidermis. Txawm hais tias muaj kev kawm ntev ntev, cov kab mob hauv nruab nrog cev tsis koom nrog cov txheej txheem pathological.
Kev kuaj kab mob
Tus kab mob no tau kuaj pom los ntawm kws kho mob dermatologist raws li cov tsos mob, anamnesis, fluorescent microscopy (ib yam ntxwv ci ntawm ciam teb ntawm dermoepidermal junctions tsis tau txiav txim siab) thiab histology nrog kev sib tham yuav tsum nrog tus kws kho mob oncologist thiab immunologist. Histologically, nrog lymphocytic infiltration, ib qho kev hloov pauv ntawm daim tawv nqaij yog txiav txim siab. Nyob rau hauv lub thickness ntawm tag nrho cov dermal txheej, muaj ib pab pawg neeg ntawm connective cov ntaub so ntswg hlwb thiab lymphocytes nyob ib ncig ntawm cov hlab ntsha.
Lwm txoj kev kuaj mob
Nyob rau hauv ntau qhov teeb meem, qog immunotyping, molecular thiab histochemical kuaj tau ua. K. Fan et al. pom zoo kuaj mob raws li cov txiaj ntsig ntawm DNA cytofluorometry nrog kev kawm txog cov lej ntawm cov hlwb ib txwm (nrog rau kev muabCov txheej txheem pathological - ntau dua 97%). Kev kuaj mob sib txawv yog ua tiav nrog cov kab mob lupus erythematosus, sarcoidosis, granuloma annulare, Biett's centrifugal erythema, toxicoderma, ib pawg ntawm cov qog lymphocytic thiab syphilis.
Kev kho mob
Kev kho tus kab mob no yog txhawm rau tshem tawm cov theem mob ntawm lymphocytic infiltration thiab ua kom ntev lub sijhawm ntawm kev tso tawm. Kev kho mob rau qhov pathology no tsis yog tshwj xeeb. Muaj kev kho mob siab hauv kev teem sijhawm ntawm cov tshuaj tiv thaiv kab mob ("Hydroxychloroquine", "Chloroquine") thiab cov tshuaj tiv thaiv tsis zoo ("Diclofenac", "Indomethacin") tom qab kev kho mob ua ntej ntawm cov kab mob sib kis ntawm lub plab zom mov. Yog hais tias lub xeev ntawm txoj hnyuv tso cai, enterosorbents yog siv. Kev siv tshuaj hormonal corticosteroid ointments thiab cream yog qhia hauv zos, nrog rau kev txhaj tshuaj tiv thaiv kab mob ntawm daim tawv nqaij nrog Betamethasone thiab Triamcinolone.
Thaum tsis kam kho, plasmapheresis txuas nrog (txog 10 zaug). Kev kho ntawm lub plab zom mov nrog lymphoplasmacytic infiltration ntawm txoj hnyuv thiab lub plab yog ze rau cov kab mob ntawm txoj hnyuv - gastritis, o nyob rau hauv cov hnyuv loj, thiab lwm yam, uas tuaj yeem ua rau muaj kev puas tsuaj rau cov mucous membranes. Txhawm rau txheeb xyuas lawv, tus neeg mob yuav tsum tau kuaj xyuas thiab kho kom zoo, uas suav nrog kev noj tshuaj tiv thaiv kab mob, tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob.tshuaj, nrog rau kev ua raws li kev noj zaub mov noj (feem ntau cov pluas noj, zam cov khoom uas ua rau fermentation, haus luam yeeb, ntsim thiab rog zaub mov).
