- 期刊
Tuberculous Gumma (Cutaneous Metastatic Tuberculous Abscess)
結核腫(皮膚轉移性結核膿瘍)
摘要
結核腫，又叫做皮膚轉移性結核膿瘍，是一種多菌型，由原發病灶血行傳播所造成的皮膚結核。我們報告一個位於右脛前的結核腫案例。一位38歲的女性，患有肺部粟粒狀結核及非霍傑金氏淋巴瘤，被發現在右脛前出現一鴿蛋大小的軟結節。病理檢查可見肉芽腫性發炎併有少量的巨大細胞，及在深部真皮及皮下組織大量的發炎細胞浸潤。同時，也發現嚴重的壞死及膿瘍。Acid-fast染色發現多數染色陽性的桿菌。組織的增減長出結核分枝桿菌。病人接受前兩個月每日rifampin，isoniazid，pyrazinamide以及ethambutol的治療以及之後四個月rifampin和isoniazid的治療。病人至今無皮膚病灶複發。
關鍵字
無資料並列摘要
Tuberculous gumma, also called metastatic tuberculous abscess, is a multibacillary type of skin tuberculosis caused by hematogenous spread of mycobacteria from a primary focus. We report a patient with tuberculous gumma on the right shin. The 68-year-old woman with pulmonary miliary tuberculosis and an occult non-Hodgkin lymphoma was found to have a pigeon-egg sized, soft nodule on the right shin. Histopathologic examination showed granulomatous inflammation with occasional giant cells and a pronounced inflammatory infiltrate in the deep dermis and subcutaneous tissue. Extensive necrosis with abscess formation was also noted. Acid-fast stain revealed multiple acid-fast bacilli. The tissue culture yielded Mycobacterium tuberculosis. The patient was treated with rifampin, isoniazid, pyrazinamide, and ethambutol daily for the initial 2 months, and isoniazid and rifampin for 4 more months. No recurrence of any skin lesion has been noted.
延伸閱讀
- 陳綺珊、王鵬惠（2023）。腹膜結核病模仿惡性腫瘤併腹膜轉移。婦癌醫學期刊，(57)，12-15。https://www.airitilibrary.com/Article/Detail?DocID=P20150521002-N202304220009-00003
- 呂耀卿（1990）。皮膚結核。當代醫學，(203)，718-720。https://doi.org/10.29941/MT.199009.0004
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- 林錫泉、曾建昌、楊國卿、高進祿、周孫衍、黃暉庭、施壽全、林當淳（1985）。結核性脾臟膿瘍－一病例報告。中華民國消化系醫學會雜誌，2(2)，101-105。https://doi.org/10.6557/GJTa.198506_2(2).0007