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纤维蛋白样坏死

显微组织切片显示图中右下角的大条血管发生纤维蛋白样坏死,H&E染色。常发生于血管炎、查格-施特劳斯氏症候群等等。

纤维蛋白样坏死(Fibrinoid necrosis)是一种特定形式的细胞坏死,此病理特征仅发生于小血管。主要是因为抗原-抗体复合体与纤维蛋白共同沉积于血管壁所诱发。常见于第三类超敏反应英语type III hypersensitivity引发的自体免疫性血管炎。在苏木精-伊红染色(H&E染色)下,病灶会呈现明显的嗜酸性英语eosinophilic[1]

疾病

纤维蛋白样坏死常发生于血管炎自体免疫疾病的患者身上,特别是全身性红斑狼疮(SLE)等会进犯肾丝球的自体免疫疾病[2]。在全身性红斑狼疮的患者身上,真皮层会发生水肿,且皮肤内的小血管附近会产生发炎反应,进而导致纤维蛋白样坏死。血清病(Serum sickness)的患者也可能发生此一情形[1]

此状况也常发生于恶性高血压英语Malignant hypertension的患者[2]。慢性高血压则也可能导致大脑皮质下动脉及穿通动脉的纤维蛋白样坏死,进而导致血管壁膨出形成微动脉瘤(microaneurysms),此类情形又称为夏科特–布查德微动脉瘤英语Charcot–Bouchard aneurysm(Charcot–Bouchard aneurysm)。动脉瘤因为管壁较薄,可能诱发自发性脑出血[3]

参考文献

  1. ^ 1.0 1.1 Robbins and Cotran pathologic basis of disease. Kumar, Vinay, Abbas, Abul K., Aster, Jon C., Perkins, James A. Ninth. Philadelphia, PA. 2014. ISBN 9781455726134. OCLC 879416939. 
  2. ^ 2.0 2.1 Damjanov, Ivan. Chapter 1 - Cell Pathology. Damjanov, Ivan (编). Pathology Secrets (Third Edition). Philadelphia: Mosby. 2009-01-01: 7–18. ISBN 978-0-323-05594-9 (英语). 
  3. ^ Chung, Chin‐Sang; Caplan, Louis R. Chapter 45 - Stroke and Other Neurovascular Disorders. Goetz, Christopher G. (编). Textbook of Clinical Neurology (Third Edition). Philadelphia: W.B. Saunders. 2007-01-01: 1019–1051. ISBN 978-1-4160-3618-0 (英语). 
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纤维蛋白样坏死
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