病理組織学的ならびに細胞免疫学的観点からみた先天性胆道閉鎖症について

抄録

Postoperative cholangitis is continuously a serious problem for congenital biliary atresia to date. Repeating biliary infection may be a cause of subsequent liver cirrhosis and portal hypertention. There are several reasons for repeating ascending cholangitis. The purpose of this paper is to define the cellular immunity in patients with congenital biliary atresia from the histopathological point of view. The thymus, lymphnodes, spleen and adrenal glands of thirteen autopsy cases of congenital biliary atresia were reviewed in comparison with 10 cases of malignancy, 10 septicemia, 10 cardiac failure and 4 sudden death. The findings seen in patients with congenital biliary atresia are (1) atrophy of the thymus, (2) atrophy of the lymphnodes and bilirubin accumulation in the macrophages, (3) atrophy of the white pulp and marked congestion and fibroadenia of the red pulp of the spleen and (4) hyperplasia of the reticular layer of the adrenal cortex. These findings suggested a presence of some defects in the cellular immunity in patients with congenital biliary atresia with repeating cholangitis.