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尿液脱落细胞检查

hay 离线

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楼主 发表于 2006-11-08 11:55|举报|关注(1)
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50岁,女, 肾移植后, 你的诊断?
尿液脱落细胞检查图1
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雪莲 离线

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1 楼    发表于2006-11-08 19:46:00举报|引用
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查见恶性细胞?不太会看
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伟伟 离线

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2 楼    发表于2006-11-08 20:13:00举报|引用
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细胞核大深染,但还算细腻吧,胞浆里是吞噬物吗?我只能说是查见核异型细胞。
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HHX 离线

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3 楼    发表于2006-11-09 15:30:00举报|引用
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有病史就好诊断了。

我的诊断是, CMV  (Cytomegalovirus):较大的核,伴有蓝黑色的 inclusion,核周可见清晰的perinuclear clearing。核膜显得略厚一些但无不规则性。

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4 楼    发表于2006-11-09 20:48:00举报|引用
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我的诊断是, CMV  (Cytomegalovirus):较大的核,伴有蓝黑色的 inclusion,核周可见清晰的perinuclear clearing。核膜显得略厚一些但无不规则性。
同意巨细胞病毒感染的细胞改变。有明显的核内包涵体。


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伟伟 离线

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5 楼    发表于2006-11-10 22:09:00举报|引用
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啊,的确是有核内包涵体
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雪莲 离线

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6 楼    发表于2006-11-10 22:56:00举报|引用
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两位老师可真厉害啊!佩服!
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mjma 离线

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7 楼    发表于2006-11-11 09:57:00举报|引用
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本帖最后由 于 2006-11-11 10:00:00 编辑 These atypical cells with enlarged and hyperchromatic nuclei are indeed infected by a virus; however, the etiologic agent is a type of human polyomavirus known as BK virus rather than CMV suggested. Human polyomaviruses are a group of human papovaviruses. They are related to two famus viruses - JC virus that causes PML (progressive multifocal leukoencephalopathy) of the brain and spinal cord, and SV40 (simian virus 40) that is very oncogenic in experimenal animal models. Like JC virus, BK virus is considered ubiquitous. A majority of human beings are exposed to these viruses early in life (evidenced by high incidence of positive serology in adults), but the virus is almost never completely cleared. Instead, they remain dormant in small copy numbers in selected tissue types (BK virun in urologic system, JC virus in central nervous system), and infection can be reactivated when the host is immunocompromised (iatrogenic immunosuppression in organ transplant recipients, chemotherapy-induced myelosuppression, HIV infection). The differential diagnosis is high grade urothelial dysplasia or urothelial carcinoma (including invasive and flat in situ carcinomas). For this reason, these cells have been nicknamed "decoy" cells. When diagnosed, patients with BK virus nephropathy (reduced renal function) should be managed accordingly - reduction of immunosuppressive therapy and/or antiviral therapy. More information on this entity can be found in the internet. For example, http://www.viracor.com/diagnostic-virals-bk_overview.htm.
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伟伟 离线

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8 楼    发表于2006-11-13 22:13:00举报|引用
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以下是引用mjma 在2006-11-11 9:57:00的发言:

These atypical cells with enlarged and hyperchromatic nuclei are indeed infected by a virus; however, the etiologic agent is a type of human polyomavirus known as BK virus rather than CMV suggested. Human polyomaviruses are a group of human papovaviruses. They are related to two famus viruses - JC virus that causes PML (progressive multifocal leukoencephalopathy) of the brain and spinal cord, and SV40 (simian virus 40) that is very oncogenic in experimenal animal models.
Like JC virus, BK virus is considered ubiquitous. A majority of human beings are exposed to these viruses early in life (evidenced by high incidence of positive serology in adults), but the virus is almost never completely cleared. Instead, they remain dormant in small copy numbers in selected tissue types (BK virun in urologic system, JC virus in central nervous system), and infection can be reactivated when the host is immunocompromised (iatrogenic immunosuppression in organ transplant recipients, chemotherapy-induced myelosuppression, HIV infection). The differential diagnosis is high grade urothelial dysplasia or urothelial carcinoma (including invasive and flat in situ carcinomas). For this reason, these cells have been nicknamed "decoy" cells. When diagnosed, patients with BK virus nephropathy (reduced renal function) should be managed accordingly - reduction of immunosuppressive therapy and/or antiviral therapy. More information on this entity can be found in the internet. For example, http://www.viracor.com/diagnostic-virals-bk_overview.htm.

翻译:这些具有大而深染核的细胞确实是病毒感染细胞,但病原是一种称为BK病毒的人类多瘤病毒类感染,而不是CMV。人类多瘤病毒是人类乳头瘤病毒中的一组。其与两个家族病毒相关——JC病毒(可导致脑和脊髓进展性多灶性脑白质病)和猿病毒40(在体外试验中有高致瘤性)。现在认为JC病毒、BK病毒广泛存在。大多数人在很小时就暴露于这些病毒,但是病毒几乎不可能被完全清除,而是以很少拷贝数量选择性的存在于各种组织中(BK病毒主要在泌尿系、JC病毒主要在中枢神经系统),当机体免疫力下降时便会卷土重来。鉴别诊断是高级别尿路上皮异型增生或是尿路上皮癌(包括侵袭性或原位癌)故此,这些细胞被形象的称为“诱饵"细胞。当诊断了BK病毒感染性肾病后,应减少免疫抑制剂治疗剂量和/或抗病毒治疗。更多信息可查询http://www.viracor.com/diagnostic-virals-bk_overview.htm.
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ren 离线

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9 楼    发表于2006-11-16 06:56:00举报|引用
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精彩,谢谢HAY、HHX、mjma、 伟伟
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小荷 离线

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10 楼    发表于2006-11-16 10:04:00举报|引用
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太好了!学习!谢谢!
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hay 离线

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11 楼    发表于2006-11-21 11:22:00举报|引用
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谢谢MJMA的讲解.

Negaive for malignant cell
effects of polyomavirus

Don't overcall "urothelial carcinoma"!
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云中漫步 离线

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12 楼    发表于2006-11-21 20:45:00举报|引用
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学习!谢谢!
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绝世好片 离线

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13 楼    发表于2009-09-16 15:30:00举报|引用
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 学习!收藏
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莫恩智 离线

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14 楼    发表于2009-11-06 02:11:00举报|引用
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 学习,好像浆内有淡红的包函体
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